[Unexplained multiple effusions as a manifestation of chronic graft-versus-host disease after allogeneic...

To analyze the presentations and treatments of unexplained multiple effusions after allogeneic hematopoietic transplantation (allo-HSCT) and their relationships with chronic graft-versus-host disease (cGVHD).

The data of 1385 allo-HSCT patients from Jan.1999 to Nov. 2008 in our institute were reviewed retrospectively.

cGVHD occurred in 911 patients, including 327 (35.8%) limited cGVHD, and 198 (21.7%) extensive cGVHD. Effusions were identified in 28 patients. Nine cases were from infections and two tumor relapses. Cirrhosis and hypoproteinemia caused ascites in 6 patients. The small amount pericardial effusions occurred in 7 patients, which were related to the toxicity of drugs. The remaining 4 patients had large and recurrent sterile effusions involving peritoneal, pericardial, pleural cavities and/or testicular sheath cavity. These 4 cases were all middle aged men and received transplantation from HLA identical siblings. The effusions had an insidious onset and were or were proved to be transudate. Examinations of the effusions for bacteria, virus and yeast were negative. The only diagnoses of the patients were cGVHD. All of the patiants responded to low dose steroid and alive, but only one achieved complete remission.

The unexplained recurrent multiple effusions after allo-HSCT might be a rare manifestation of chronic GVHD.