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Case Report

The Effect of Tetrastarch Solution for Capillary Leak Syndrome Following Allogeneic Hematopoietic Stem Cell Transplantation: A Report of 2 Cases

1
Division of Clinical Pharmacy, Department of Pharmacy, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
2
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
3
Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children’s Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, Taoyuan 333, Taiwan
4
Department of Nursing, Chang Gung University and Memorial Hospital, 333 Taoyuan, Taiwan
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2021, 13(1), 8750; https://doi.org/10.4081/hr.2021.8750
Submission received: 6 July 2020 / Revised: 1 October 2020 / Accepted: 1 February 2021 / Published: 5 March 2021

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.
Keywords: allogeneic hematopoietic stem cell transplantation; capillary leak syndrome; tetrastarch allogeneic hematopoietic stem cell transplantation; capillary leak syndrome; tetrastarch

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MDPI and ACS Style

Lin, Y.-T.; Wong, C.-Y.; Chang, T.-Y.; Chiu, C.-C.; Wen, Y.-C.; Jaing, T.-H. The Effect of Tetrastarch Solution for Capillary Leak Syndrome Following Allogeneic Hematopoietic Stem Cell Transplantation: A Report of 2 Cases. Hematol. Rep. 2021, 13, 8750. https://doi.org/10.4081/hr.2021.8750

AMA Style

Lin Y-T, Wong C-Y, Chang T-Y, Chiu C-C, Wen Y-C, Jaing T-H. The Effect of Tetrastarch Solution for Capillary Leak Syndrome Following Allogeneic Hematopoietic Stem Cell Transplantation: A Report of 2 Cases. Hematology Reports. 2021; 13(1):8750. https://doi.org/10.4081/hr.2021.8750

Chicago/Turabian Style

Lin, Yu-Ting, Chun-Ying Wong, Tsung-Yen Chang, Chia-Chi Chiu, Yu-Chuan Wen, and Tang-Her Jaing. 2021. "The Effect of Tetrastarch Solution for Capillary Leak Syndrome Following Allogeneic Hematopoietic Stem Cell Transplantation: A Report of 2 Cases" Hematology Reports 13, no. 1: 8750. https://doi.org/10.4081/hr.2021.8750

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