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Central Nervous System Complications and Outcomes After Allogeneic Hematopoietic Stem Cell Transplantation.
- Source :
-
Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2015 Oct; Vol. 15 (10), pp. 606-11. Date of Electronic Publication: 2015 Jun 19. - Publication Year :
- 2015
-
Abstract
- Background: Central nervous system complications (CNSC) can be the cause of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aimed to determine the incidence of CNSC and its impact on survival.<br />Patients and Methods: This retrospective cohort study included patients with hematologic disorders who received allo-HSCT between 2002 and 2011 at the University of Nebraska Medical Center.<br />Results: Of the 351 patients identified, 45 developed CNSC (12.8%). The 100-day cumulative incidence of CNSC was 8% (95% confidence interval, 8-15). The most common CNSC included posterior reversible encephalopathy syndrome (40%), stroke or transient ischemic attack (24%), seizures (20%), and infection (9%). The 5-year overall survival was significantly lower among patients with versus without CNSC (14% vs. 44%, P = .0004). In multivariate analysis, the risk of mortality for patients with versus without CNSC was significantly higher (hazard ratio, 1.56; 95% confidence interval, 1.03-2.36; P = .04).<br />Conclusion: The occurrence of CNSC after allo-HSCT was associated with reduced survival. Identifying patients at risk, monitoring, early detection, and management of CNSC after allo-HSCT are needed to improve outcomes.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Child
Child, Preschool
Female
Humans
Infant
Leukemia, Myeloid, Acute mortality
Male
Middle Aged
Multivariate Analysis
Posterior Leukoencephalopathy Syndrome mortality
Proportional Hazards Models
Retrospective Studies
Risk Factors
Seizures mortality
Stroke mortality
Transplantation, Homologous
Treatment Outcome
Young Adult
Hematopoietic Stem Cell Transplantation adverse effects
Leukemia, Myeloid, Acute therapy
Posterior Leukoencephalopathy Syndrome etiology
Seizures etiology
Stroke etiology
Subjects
Details
- Language :
- English
- ISSN :
- 2152-2669
- Volume :
- 15
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Clinical lymphoma, myeloma & leukemia
- Publication Type :
- Academic Journal
- Accession number :
- 26184063
- Full Text :
- https://doi.org/10.1016/j.clml.2015.06.004