UNEXPLAINED EFFUSIONS - ASSOCIATION WITH ALLOGENEIC BONE-MARROW TRANSPLANTATION AND ACUTE OR CHRONIC GRAFT-VERSUS-HOST DISEASE

We evaluated patients presenting with large and recurrent sterile sero sal effusions following bone marrow transplants, From a review of the Minnesota BMT Database from 1974 to 1993, seven patients with unexplai ned multiple effusions involving two or more of the pleural, pericardi al or peritoneal cavities were identified, Patients with veno-occlusiv e disease (VOD), infections, cardiac insufficiency, tumor relapse and GM-CSF toxicity were excluded, All had onset following engraftment and six occurred before day 100, Unexplained multiple effusions were obse rved in recipients of allogeneic transplants but not autologous transp lants and were found only in patients with acute and/or chronic GVHD. Five of seven patients also had cytomegalovirus (CMV) disease. Multipl e effusions appear to be part of the presentation of severe acute or c hronic GVHD, often in association with CMV disease in patients who rec eive allogeneic donor marrow.