Acute Complications in Hematopoietic Stem Cell Transplantation and Cellular Immunotherapy

Anil P. George*, William T. Tse

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for many pediatric diseases. Cellular immunotherapy, such as the use of chimeric antigen receptor T cells, has emerged recently as a highly effective modality to treat refractory lymphoid malignancies. Although HSCT and cellular immunotherapy are now considered essential parts of the current therapeutic armamentarium, both are associated with a wide range of acute complications, many of which are unique to these treatment modalities. These acute complications are seen not only in hospitalized patients but also in patients in the ambulatory setting, including the emergency department. Emergency care providers will need to be able to recognize these complications and provide appropriate initial assessment and management. In this review, we describe the acute complications associated with HSCT and cellular immunotherapy, with the emphasis on their recognition, workup, and treatment.

Original languageEnglish (US)
Pages (from-to)162-175
Number of pages14
JournalClinical Pediatric Emergency Medicine
Volume19
Issue number2
DOIs
StatePublished - Jun 2018

Keywords

  • CAR-T–associated encephalopathy syndrome
  • acute complications
  • bronchiolitis obliterans
  • cellular immunotherapy
  • chimeric antigen receptor T cells
  • cryptogenic organizing pneumonia
  • cytokine release syndrome
  • diffuse alveolar hemorrhage
  • engraftment syndrome
  • graft-versus-host disease
  • hematopoietic stem cell transplantation
  • hemorrhagic cystitis
  • hepatic sinusoidal obstruction syndrome
  • idiopathic pneumonitis syndrome
  • immunosuppression
  • neutropenic enterocolitis
  • neutropenic fever
  • posterior reversible encephalopathy syndrome
  • transplant-associated thrombotic microangiopathy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

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