Spitzer proposed criteria for the engraftment syndrome that occurs in some patients following bone marrow or stem cell transplantation. The author is from Massachusetts General Hospital in Boston.
Engraftment was defined as a neutrophil count >= 500 per µL for 2 consecutive days.
Onset of syndrome: within 96 hours of engraftment
(1) temperature >= 38.3°C AND no identifiable source of infection
(2) erythroderma involving > 25% of body surface area AND rash not due to a medication
(3) noncardiogenic pulmonary edema with hypoxia and diffuse pulmonary infiltrates
(1) hepatic dysfunction - one or both of the following:
(1a) total serum bilirubin >= 2 mg/dL
(1b) serum transaminase values >= 2 times normal (presumable upper limit of normal)
(2) renal insufficiency (with serum creatinine increased >= 2 times the baseline value)
(3) increase in weight with weight >= 102.5% of baseline
(4) transient encephalopathy AND no other explanation
• The presence of 1 major AND several minor might mean something but this was not defined in the paper.
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Specialty: Clinical Laboratory, Hematology Oncology, General Surgery