Bone marrow transplantation (Basingstoke), 2008-02, Vol.41 (3), p.253-259
2008
Details
- Autor(en) / Beteiligte
- Titel
- Diagnostic and therapeutic implications of neurological complications following paediatric haematopoietic stem cell transplantation
- Ist Teil von
- Bone marrow transplantation (Basingstoke), 2008-02, Vol.41 (3), p.253-259
- Ort / Verlag
- Basingstoke: Nature Publishing Group
- Erscheinungsjahr
- 2008
- Link zum Volltext
- Quelle
- Free E-Journal (出版社公開部分のみ）
- Beschreibungen/Notizen
- Neurological complications are a relevant cause of morbidity and mortality after haematopoietic stem cell transplantation (SCT). We retrospectively analysed neurological complications of 165 paediatric patients who underwent SCT between 1996 and 2003. In all, 111 (67%) transplantations were allogeneic and 54 (33%) transplantations were autologous. Post-SCT neurological complications were seen in 24% of patients. They were seen in six children after autologous SCT and in 11 and 23 cases after allogeneic-related and -unrelated SCT. Neurological symptoms occurred between day +22 and +912 after transplantation and were classified into two groups. The first group (n=21) offered non-repetitive symptoms lasting less than 24 h without any cerebral imaging and cerebrospinal fluid(CSF) abnormalities. The second group (n=19) was characterized by progressive neurological symptoms, pathological MRI findings and/or abnormal results in CSF. Those with a progressive clinical course resulted from infections (n=10), drug toxicity (n=5), cerebrovascular events (n=2) and the central nervous system (CNS) relapse of the underlying disease (n=2). In particular, cerebral aspergillosis and toxoplasmosis after allogeneic unrelated SCT are a major challenge and are associated with a high mortality. In conclusion, our data suggest that patients presenting with progressive neurological symptoms after SCT require prompt diagnostic procedures and initiation in antimicrobial therapy in case of any findings suggestive of CNS infection.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0268-3369eISSN: 1476-5365DOI: 10.1038/sj.bmt.1705905Titel-ID: cdi_proquest_miscellaneous_20807463
- Format
- –
- Schlagworte
- Abnormalities, Adolescent, Adult, Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy, Antiinfectives and antibacterials, Aspergillosis, Aspergillus, Autografts, Biological and medical sciences, Bone marrow, Bone marrow, stem cells transplantation. Graft versus host reaction, Central nervous system, Cerebrospinal fluid, Child, Child, Preschool, Cohort Studies, Complications, Diagnostic systems, Female, Health aspects, Hematopoietic Stem Cell Transplantation - adverse effects, Hematopoietic stem cells, Hospitals, Pediatric, Humans, Infant, Infections, Magnetic resonance imaging, Male, Medical sciences, Meningitis - diagnosis, Meningitis - etiology, Meningitis - therapy, Morbidity, Mortality, Neoplasm Recurrence, Local - complications, Nervous system diseases, Neurological complications, Neurotoxicity Syndromes - diagnosis, Neurotoxicity Syndromes - etiology, Neurotoxicity Syndromes - therapy, Patients, Pediatrics, Retrospective Studies, Risk factors, Seizures - diagnosis, Seizures - etiology, Seizures - therapy, Signs and symptoms, Stem cell transplantation, Stem cells, Survival Analysis, Toxicity, Toxoplasmosis, Transfusions. Complications. Transfusion reactions. Cell and gene therapy, Transplantation