Neurological complications after allogeneic hematopoietic stem cell transplantation in children, a single center experience

Azık, Fatih Mehmet; Erdem, Arzu Yazal; Tavil, Betül; Bayram, Cengiz; Tunç, Bahattin; Uçkan, Duygu

doi:10.1111/petr.12265

Cited by 17 publications

(21 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our cumulative incidence of CNSC of 12.2% at 1 year and 14.5% at 5 years is lower than the majority of prior reports. [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] This finding is consistent with the overall trend of reduced morbidity and mortality associated with HCT over time. 64 Despite a relatively low overall incidence of NCs we still found that development of a CNSC portends a poor prognosis and was associated with decreased PFS and OS, and increased NRM, consistent with previous studies.…”

Section: Discussionsupporting

confidence: 78%

“…Several studies have sought to define the incidence and characteristics of NCs associated with HCT, with estimates of incidence varying considerably, from~8 to 65% depending on the study design, types of NCs included, patient population and transplantation setting. [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] Autopsy studies have uncovered neuropathological findings in as high as 90% of patients who have died following HCT. [49][50][51] Many of these studies have found unfavorable survival among patients who develop central nervous system (CNS) complications (CNSCs).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neurologic complications after allogeneic hematopoietic stem cell transplantation: risk factors and impact

Dowling

Dey

et al. 2017

Bone Marrow Transplant

View full text Add to dashboard Cite

Neurologic complications (NCs) may be a significant source of morbidity and mortality after hematopoietic cell transplantation (HCT). We performed a retrospective study of 263 consecutive patients undergoing allogeneic HCT for hematological malignancies to determine the incidence, risk factors and clinical impact of NCs in the first 5 years after HCT. We determined the incidence of central nervous system (CNS) infection, intracranial hemorrhage, ischemic stroke, metabolic encephalopathy, posterior reversal encephalopathy syndrome, seizure and peripheral neuropathy. In all, 50 patients experienced 63 NCs-37 early (⩽day +100), 21 late (day +101 to 2 years) and 5 very late (2 to 5 years). The 1- and 5-year cumulative incidences of all NCs were 15.6% and 19.2%, respectively, and of CNS complication (CNSC; all of the above complications except peripheral neuropathy) were 12.2 and 14.5%. Risk factors for CNSC were age (hazard ratio (HR)=1.06 per year, P=0.0034), development of acute GvHD grade III-IV (HR=2.78, P=0.041), transfusion-dependent thrombocytopenia (HR=3.07, P=0.025) and delayed platelet engraftment (>90th centile; HR=2.77, P=0.043). CNSCs negatively impacted progression-free survival (HR=2.29, P=0.0001), overall survival (HR=2.63, P<0.0001) and non-relapse mortality (HR=8.51, P<0.0001). NCs after HCT are associated with poor outcomes, and usually occur early after HCT.

show abstract

Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Neurologic complications after allogeneic hematopoietic stem cell transplantation: risk factors and impact

Dowling

Dey

et al. 2017

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…In another study by Azik et al 26 , neurological complication frequency of 89 allo-HSCT children was reported as 11%. We found neurological complication in 2 of 51 children (3.9%); one had encephalopathy and the other one had transverse myelitis secondary to varicella infection.…”

Section: Discussionmentioning

confidence: 93%

Long-Term Side Effects of Hematopoietic Stem CeTransplantation in Children: A Single Center Experience.

Babacan¹

2015

UHOD

View full text Add to dashboard Cite

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has the potention to provide curative therapy for selected benign and malignant disorders. In patients undergoing allo-HSCT in childhood, long term side effects are increased as with the prolonged survival time. Fifty-one patients underwent allo-HSCT between 2001-2014 and survived for at least two years were enrolled in this study. Clinical evaluation with detailed physical examination and required laboratory tests were done routinely to determine long term side effects. Mean follow-up period after allo-HSCT was 68.3±31.4 months (range: 24-141 months), patients' age average was 9.3 ± 4.9 years (range: 6 moths-17 years), 56.9% of them were male, and 92.2 % (n= 47) of donors were match family donors. We determined long term side effects in 56.8% of patients. Most of the long term side effects were endocrine complications with 17.6%. Oculary long term side effects were found in 15.7% and associated with haploidentical and match unrelated donor (MUD) transplantations (p= 0.002). We found that chronic graft versus host disease (GVHD) rate was increased with MUD transplantation (p=0.003) and acute liver GVHD (p= 0.002). Osteoporosis frequency was positively correlated with follow-up time (p= 0.002) and found much more in malign disorders than benign ones (p=0.002). Osteoporosis was rarely found in conditioning regimens included cyclophosphamide (p= 0.004). Long-term side effect risk was higher in patients underwent allo-HSCT in older age (p= 0.003). Patients need to be monitored routinely for a long time after allo-HSCT. Haploidentical and MUD transplantation increase long term side effects. Future wide-spread studies are necessary to determine long term side effects of allo-HSCT-received children.

show abstract

“…The CNS complications after HSCT are common 12) . The clinical manifestations include seizures, headache, altered level of consciousness, involuntary movements, ataxia, speech impairment, and delirium 13) 14) . The previous studies reported that 70% of the CNS complications occur within the first 100 days after HSCT 3) .…”

Section: Discussionmentioning

confidence: 99%

Cerebral salt-wasting syndrome after hematopoietic stem cell transplantation in adolescents: 3 case reports

Jeon

Lee

Jung

et al. 2015

Ann Pediatr Endocrinol Metab

View full text Add to dashboard Cite

Cerebral salt-wasting syndrome (CSWS) is a rare disease characterized by a extracellular volume depletion and hyponatremia induced by marked natriuresis. It is mainly reported in patients who experience a central nervous system insult, such as cerebral hemorrhage or encephalitis. The syndrome of inappropriate antidiuretic hormone secretion is a main cause of severe hyponatremia after hematopoietic stem cell transplantation, whereas CSWS is rarely reported. We report 3 patients with childhood acute leukemia who developed CSWS with central nervous system complication after hematopoietic stem cell transplantation. The diagnosis of CSW was made on the basis of severe hyponatremia accompanied by increased urine output with clinical signs of dehydration. All patients showed elevated natriuretic peptide and normal antidiuretic hormone. Aggressive water and sodium replacement treatment was instituted in all 3 patients and 2 of them were effectively recovered, the other one was required to add fludrocortisone administration.

show abstract

Neurological complications after allogeneic hematopoietic stem cell transplantation in children, a single center experience

Cited by 17 publications

References 24 publications

Neurologic complications after allogeneic hematopoietic stem cell transplantation: risk factors and impact

Neurologic complications after allogeneic hematopoietic stem cell transplantation: risk factors and impact

Long-Term Side Effects of Hematopoietic Stem CeTransplantation in Children: A Single Center Experience.

Cerebral salt-wasting syndrome after hematopoietic stem cell transplantation in adolescents: 3 case reports

Contact Info

Product

Resources

About