Epidemiology

• More common with auto-SCT than allo-SCT
• Occurs in 7-9% of SCT’s
• Occurs during neutrophil engraftment after SCT
• Prevention: shielding the lung during TBI may prevent the pulmonary aspect of engraftment syndrome in some cases
• Associated with poor long-term survival in breast cancer-related cases

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Physiology

• xxx

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Diagnostic Criteria

Major Criteria

• Fever >38.8 with no identifiable infectious etiology
• Erthrodermatous skin rash involving >25% of BSA and not attributable to a medication
• Non-cardiogenic pulmonary edema: diffuse pulmonary infiltrates + hypoxemia

Minor Criteria

• Hepatic dysfunction: TBili >2 mg/dL or transaminases >2x normal
• AKI: CR >2x normal
• Weight gain: >2.5% of baseline body weight
• Transient encephalopathy unexplained by other causes

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Clinical

• As above
• Pleural effusions: may occur

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Treatment

• Steroid-responsive

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References

• xxx