In:
European Journal of Haematology, Wiley, Vol. 105, No. 6 ( 2020-12), p. 722-730
Abstract:
Major complications affecting the central nervous system (CNS) present a challenge after allogeneic stem cell transplantation (allo‐SCT). Methods Incidence, risk factors, and outcome were retrospectively analyzed in 888 patients in a monocentric study. Results Cumulative incidence (CI) of major CNS complications at 1 year was 14.8% (95%CI 12.3%‐17.2%). Median follow‐up is 11 months. CNS complications were documented in 132 patients: in 36 cases, classified metabolic; 26, drug‐related neurotoxicity (14 attributed to cyclosporine A, 4 to antilymphocyte globulin); 11, cerebrovascular (ischemic n = 8, bleeding n = 3); 9, infections; 9, psychiatric; and 9, malignant. The cause of CNS symptoms remained unclear for 37 patients (28%). Multivariate analysis demonstrated an association of CNS complication with patient age ( P 〈 .001). The estimated OS of patients with any CNS complication was significantly lower than in patients without neurological complications ( P 〈 .001), and the CI of non‐relapse mortality (NRM) was higher for patients with CNS complication ( P 〈 .001). A significant negative impact on survival can only be demonstrated for metabolic CNS complications and CNS infections (NRM, P 〈 .0001 and P = .0003, respectively), and relapse ( P 〈 .0001). Conclusion CNS complications after allo‐SCT are frequent events with a major contribution to morbidity and mortality. In particular, the situations of unclear neurological complications need to be clarified by intensive research.
Type of Medium:
Online Resource
ISSN:
0902-4441
,
1600-0609
Language:
English
Publisher:
Wiley
Publication Date:
2020
detail.hit.zdb_id:
2027114-1
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