Table 2 Diagnostic criteria for the vascular complications.

From: Early vascular toxicity after pediatric allogeneic hematopoietic stem cell transplantation

 

Diagnostic criteria

Supplemental criteriae

CLS (Pagliuca et al. [21])

Rapid weight gain (>3% in 24 h)

Hypoalbuminemia

Edema (generalized edema, pericarditis, pleural effusion or ascites) requiring intensive diuretic medication

Renal insufficiency

 

Hypotension

 

Tachycardia

TMA (Cho et al. [19])

Normal coagulation assaysa

Gastrointestinal bleeding

Decrease in hemoglobin concentration

Pericardial effusion

Thrombocytopeniab

Acute kidney injury

Decrease in haptoglobin concentrationc

Respiratory failure

Increase in serum LDH

Neurologic symptoms (seizures)

Schistocytes on peripheral blood smear

Pulmonary hypertension

Increase in serum creatinined

Hemorrhagic cystitis

Negative Coombs test

Fever of unknown origin

VOD/SOS (EBMT [20])

No limitation for time of VOD onset

The presence of two or more of the following:

 Unexplained consumptive and transfusion-refractory thrombocytopenia

 Unexplained weight gain for three consecutive days despite the use of diuretics or weight gain >5% above baseline

 Hepatomegaly

 Ascites

 Rising bilirubin from baseline for 3 consecutive days or bilirubin ≥2 mg/dL within 72 h

  1. CLS capillary leak syndrome, TMA thrombotic microangiopathy, VOD veno-occlusive disease, SOS sinusoidal obstruction syndrome, LDH lactate dehydrogenase.
  2. aCoagulation assays include prothrombin time and activated partial thromboplastin time.
  3. bDecrease <50 × 109/L or a ≥50% decrease.
  4. cDecrease (below the lower limit of normal).
  5. dDoubling relative to patient’s pre-HSCT baseline.
  6. eClinical findings considered as supportive for the diagnosis especially in lack of all the laboratory tests needed to criteria.
Back to article page