Neurologic complications after allogeneic hematopoietic stem cell transplantation: risk factors and impact
Neurologic complications after allogeneic hematopoietic stem cell transplantation: risk factors and impact
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DOI：
10.1038/bmt.2017.239
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发表时间：
2018-02-01
影响因子：
4.8
通讯作者：
Ballen, K. K.
中科院分区：
文献类型：
--
作者：
Dowling, M. R.;Li, S.;Ballen, K. K.
神经系统并发症（NCs）可能是造血细胞移植（HCT）术后发病率和死亡率的重要来源。我们对263例连续接受同种异体血液恶性肿瘤HCT的患者进行了回顾性研究，以确定HCT后前5年NCs的发病率、危险因素和临床影响。我们确定了中枢神经系统（CNS）感染、颅内出血、缺血性中风、代谢性脑病、后反转脑病综合征、癫痫和周围神经病变的发生率。总共有50例患者早期出现63例nc -37（第90百分位；HR = 2.77, P = 0.043）。CNSCs对无进展生存期（HR = 2.29, P = 0.0001）、总生存期（HR = 2.63, P < 0.0001）和非复发死亡率（HR = 8.51, P < 0.0001）有负面影响。HCT后的nc与预后不良相关，通常发生在HCT后早期。
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 ( 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.