The effect of tetrastarch solution for capillary leak syndrome following allogeneic hematopoietic stem cell transplantation: A report of 2 cases

  • Yu-Ting Lin Division of Clinical Pharmacy, Department of Pharmacy, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Province of China.
  • Chun-Ying Wong College of Medicine, Chang Gung University, Taoyuan, Taiwan, Province of China.
  • Tsung-Yen Chang Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children’s Hospital, Chang Gung University, Taoyuan, Taiwan, Province of China.
  • Chia-Chi Chiu Department of Nursing, Chang Gung University and Memorial Hospital, Taoyuan, Tajikistan.
  • Yu-Chuan Wen Department of Nursing, Chang Gung University and Memorial Hospital, Taoyuan, Taiwan, Province of China.
  • Tang-Her Jaing | jaing001@cgmh.org.tw Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children’s Hospital, Chang Gung University, Taoyuan, Taiwan, Province of China.

Abstract

Capillary leak syndrome (CLS) is a severe complication of allogeneic hematopoietic stem cell transplantation (HSCT) characterized by weight gain, generalized edema, hypotension, and hypoalbuminemia. The primary pathogenesis is injury of the capillary endothelium resulting in a loss of intravascular fluid into the interstitial space. Treatment is limited to vascular endothelial growth factor withdrawal and systemic corticosteroids. We report two cases with CLS where weight gain, ascites, and hypotension developed after neutrophil engraftment following allogeneic HSCT. We obtained serial electrolytes, blood urea nitrogen, creatinine, and albumin from these patients. Ultrasound with Doppler tracing performed on both patients showed no reversal of portal venous flow. Issues addressed were the restoration of regular hydration by hydroxyethyl starch (HES) solutions, together with systemic corticosteroids and forced diuresis. Tetrastarch was administered 10 and 20 days, respectively. Both patients recovered without sequelae. CLS is a frequent complication after allogeneic HSCT. The effects of HES on CLS merit further consideration and prospective study.

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Published
2021-03-05
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Case Reports
Keywords:
Allogeneic hematopoietic stem cell transplantation, capillary leak syndrome, tetrastarch
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How to Cite
Lin, Y.-T., Wong, C.-Y., Chang, T.-Y., Chiu, C.-C., Wen, Y.-C., & Jaing, T.-H. (2021). The effect of tetrastarch solution for capillary leak syndrome following allogeneic hematopoietic stem cell transplantation: A report of 2 cases. Hematology Reports, 13(1). https://doi.org/10.4081/hr.2021.8750