Pericardial Effusion Post Transplantation Predicts Inferior Overall Survival Following Allo-hematopoietic Stem Cell Transplant

?Purpose? To determine the incidence, risk factors of PE and correlate it with mortality over the subsequent 5 years.?Methods?Consecutive adult patients(age? 18 years) who received HSCT at the Hematology Department in Tongji Hospital between March 2003 and January 2014 were included in this study. All available medical records, notes, imaging reports, correspondence and autopsy reports were reviewed for patients remained for study analysis. 108 autologous and 208 allo-HSCT patients were included for the study analysis, including 69 PE patients. Collect all the possible reasons for PE, data about the OS,relapse, TRM of each patients. Kaplan-Meier estimate was calculated, and difference in survival was assessed using log-rank test. Cumulative incidence estimates were calculated for TRM and relapse. Covariate and multivariate Cox proportional hazards model was used to examine factors contributing to PE.?Results?The presence or absence of PE had significant impact on 5-year OS and 5-year TRM after allo-HSCT. Further analysis about death due to GVHD or infection also showed great differences between patients with and without PE. On the contrary, we did not find significant differences between patients with and without PE due to relapse or progression. Myeloablative conditioning regimen and relapse were the two significant risk factors for developing early onset PE in autologous and allo-HSCT, respectively. Neutrophil engraftment and GVHD prophylaxis were risk factors for developing late onset PE in allo-HSCT.?Conclusion?Post-transplant PE could be regarded as a new predictor for inferior survival and high mortality following adult allo-HSCT. Myeloablative conditioning regimen, relapse, neutrophil engraftment and GVHD prophylaxis were risk factors for developing PE following HSCT. It is imperative to initiate early prophylaxis and treatment for PE to improve the outcome.