Incidence, Risk Factors, and Outcome of Immune-Mediated Neuropathies (IMNs) following Haploidentical Hematopoietic Stem Cell Transplantation.
Biol Blood Marrow Transplant
; 25(8): 1629-1636, 2019 08.
Article
em En
| MEDLINE
| ID: mdl-31048087
ABSTRACT
Immune-mediated neuropathies (IMNs) following hematopoietic stem cell transplantation have been described recently, which, excluding Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy, may present with atypical patterns. This retrospective, nested, case-control study reviewed data from 3858 patients who received haploidentical hematopoietic stem cell transplantation (haplo-HSCT) during the past 10 years at a single center, and 40 patients (1.04%) with IMN following haplo-HSCT were identified. Chronic graft-versus-host disease (cGVHD) (Pâ¯=â¯.043) and cytomegalovirus (CMV) viremia (Pâ¯=â¯.035) were recognized as independent risk factors for the development of IMN after haplo-HSCT. There were no significant differences in overall survival (Pâ¯=â¯.619), disease-free survival (Pâ¯=â¯.609), nonrelapse mortality (Pâ¯=â¯.87), or the incidence of relapse (Pâ¯=â¯.583) between patients with and without IMN after haplo-HSCT. However, patients with post-transplant IMN were at higher risk of developing cGVHD (Pâ¯=â¯.012) than patients who did not develop IMN. Twenty-four of the 40 patients with IMN (60%) attained neurologic improvement after treatments including vitamins B1 and B12 and/or immunomodulatory agents. However, 19 (47.5%) patients still had persistent motor/sensory deficits despite receiving timely treatment. More studies are needed to help develop standardized diagnostic and therapeutic strategies for patients with post-transplant IMN.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tiamina
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Vitamina B 12
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Transplante de Células-Tronco Hematopoéticas
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Síndrome de Guillain-Barré
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Polirradiculoneuropatia Desmielinizante Inflamatória Crônica
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Doença Enxerto-Hospedeiro
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Fatores Imunológicos
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Biol Blood Marrow Transplant
Assunto da revista:
HEMATOLOGIA
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TRANSPLANTE
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
China