MARROW ENGRAFTMENT AND CLINICAL MANIFESTATIONS OF CAPILLARY LEAK SYNDROME

A capillary leak syndrome occurs frequently in bone marrow transplant patients in addition to graft-versus-host-disease and infection, The u nderlying pathology is poorly understood but the clinical manifestatio ns of excessive weight gain, ascites, and edema associated with kidney and liver abnormalities suggest a common injury to multiple organs, T he clinical courses of 55 allogeneic and autologous marrow transplant recipients were retrospectively reviewed with regard to the presentati on of a capillary leak syndrome (CLS), Twenty-nine patients (53%) deve loped non-cardiogenic pulmonary edema with or without concurrent pleur al effusions; the incidence was comparable in allogeneic and autologou s recipients, Pulmonary features were accompanied by hepatic dysfuncti on in 28, renal dysfunction in 22, and central nervous system abnormal ities in 17, There was a strong correlation between time of engraftmen t and the first manifestations of CLS, both of which occurred earlier in allogeneic than in autologous transplant recipients, These data con firm that CLS occurs in both allogeneic and autologous transplant reci pients and suggest a pivotal contribution by circulating leukocytes.