CLS is one of the life-threatening early complications which
usually occur during hematopoietic stem cell infusion or hematopoietic
reconstruction process in addition to graft-versus-host-disease (GVHD) and
infection. It is characterized by unexplained episodic
capillary hyperpermeability, which causes the shift of fluid and protein
from the intravascular space to the interstitial space. However, since the
nonspecific signs and symptoms of CLS and the overlapping manifestations of
early complications after transplantation, CLS tends to be easily confused with
other early complications for clinicians. In this case, we report an adult with
refractory acute myeloid leukemia who developed fatal CLS during allo-HSCT with
review of the literature.
Allo-HSCT is a curative procedure for a subset of patients
with hematologic malignancies. However, allo-HSCT is still associated with high
treatment-related mortality due to severe infections and noninfectious
complications. Especially during hematopoietic stem cell infusion or
hematopoietic reconstruction process, a constellation of symptoms and signs
including fever, erythrodermatous skin rash, and noncardiogenic pulmonary can
be potentially fatal.
CLS is a severe early complication of HSCT characterized by
weight gain, generalized edema, hypotension,
and hypoalbuminemia. We present an allo- HSCT AML patient affected by fatal
CLS during conditioning therapy with a short survival in which the crises have
disappeared temporarily after treatment but eventually died of CLS recurrence.
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