Central Nervous System Complications and Outcomes After Allogeneic Hematopoietic Stem Cell Transplantation.
Clin Lymphoma Myeloma Leuk
; 15(10): 606-11, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-26184063
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. PATIENTS ANDMETHODS:
This retrospective cohort study included patients with hematologic disorders who received allo-HSCT between 2002 and 2011 at the University of Nebraska Medical Center.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).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.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Convulsões
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Leucemia Mieloide Aguda
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Transplante de Células-Tronco Hematopoéticas
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Acidente Vascular Cerebral
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Síndrome da Leucoencefalopatia Posterior
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article