Effect of colchicine in early onset acute pericarditis after allogeneic peripheral blood stem cell transplantation

A 48-years-old man with acute megakaryoblastic leukemia admitted to our hospital. He treated with an induction chemotherapy with idarubicin and cytarabine, and he obtained hematological complete remission after two courses of the therapy. He underwent allogeneic peripheral blood stem cell transplantation (allo-HSCT) from an HLA-matched sibling donor. He received a myeloablative conditioning regimen with busulfan (12.8 mg/kg) and cyclophosphamide (120 mg/kg). Cyclosporine and short-term methotrexate were administered to prevent graft-versus-host disease (GVHD). He developed fever and chest pain on the 8th day after allo-HSCT before neutrophil engraftment. ECG showed ST-segment elevation in Ⅱ, Ⅲ, aVF, V2-V4 and pericardial effusion was observed by echocardiography. He was clinically diagnosed as acute pericarditis. Colchicine was administered for acute pericarditis, and his symptoms rapidly improved. Although there have been known cases of pericarditis after allo-HSCT that usually occur late after allo-HSCT due to irradiation or chronic GVHD, this case was diagnosed as acute pericarditis that developed in the early post-transplant period before the hematopoietic function recovered. Our results suggest that colchicine may be effective in the treatment of acute pericarditis that develops in the early post-transplant period.