Spectrum and prognosis of neurologic complications after hematopoietic transplantation

Abstract

Severe neurologic complications after hematopoietic progenitor cell transplantations are common, vary according to the underlying disease and type of transplantation, and are associated with poor survival rates. Better prophylactic protocols and therapy for CNS infections are required in future studies.

Viral encephalitis after allogeneic stem cell transplantation: a rare complication with distinct characteristics of different causative agents

“…1,2 However, up to 25% of patients who undergo allo-SCT suffer from more severe neurological complications involving the central nervous system (CNS), frequently infections, which are associated with a poor outcome. [1][2][3][4] The leading causative organisms of CNS infections in patients with malignancies are Toxoplasma gondii and fungi, particularly Aspergillus spp., with typically localized parenchymal manifestations including abscesses or strokes. [4][5][6] Viral CNS infections have less frequently been reported in patients after allo-SCT even though they are the most common type of acute encephalitis in nonimmunocompromised hosts in Western countries.…”

“…[1][2][3][4] The leading causative organisms of CNS infections in patients with malignancies are Toxoplasma gondii and fungi, particularly Aspergillus spp., with typically localized parenchymal manifestations including abscesses or strokes. [4][5][6] Viral CNS infections have less frequently been reported in patients after allo-SCT even though they are the most common type of acute encephalitis in nonimmunocompromised hosts in Western countries. [7][8][9][10][11] The largest series published to date on viral encephalitis after allo-SCT reported on 23 human herpesvirus-6 (HHV-6) encephalitis patients.…”

Human herpes 6 virus encephalitis complicating allogeneic hematopoietic stem cell transplantation

“…6 Up to 25% of patients develop moderate to severe neurologic complications after allogeneic (allo)HSCT. 7,8 Exposure to neurotoxic medications and disruption of immunity as a part of the HSCT procedure contribute to nervous system complications. 9 In general, CNS infections post-alloHSCT have been associated with higher mortality and rejection rates, whereas long-term neurologic morbidity remains unknown.…”

“…HHV-6 (subtypes A and B) quantitative, real-time PCR was performed by extracting DNA from a 200-mL aliquot of whole blood or CSF and using primers and probes that amplify and detect a portion of the viral DNA polymerase gene as described previously. 7 The assay is able to differentiate between subtypes A and B based on melt curve analysis. The limit of detection of the PCR assay is 50 genome equivalents per 1.0 mL with a lower limit of the quantifiable range of 250 genome equivalents per 1.0 mL.…”

Neurological complications of hematopoietic stem cell transplantation (HSCT): a retrospective study in a HSCT center in Brazil

“…the authors observed that 9.7% of the children developed neurological complications classified as serious (life-threatening). the main risk factors identified were the main risk status of the underlying disease, mismatched transplantation, previous diagnosis of advanced AML, older age and the presence of grade II or higher graft-versushost-disease (GvhD) 9 . Denier et al described the spectrum and prognosis of neurological complications after hsct in a series of 361 patients.…”