Central Nervous System Complications and Outcomes after Allogeneic Hematopoietic Stem Cell Transplantation

Vijaya Raj Bhatt, Vamshi Balasetti, Jagar A. Jasem, Smith Giri, James O. Armitage, Fausto R. Loberiza, R. Gregory Bociek, Philip J. Bierman, Lori J. Maness, Julie M. Vose, Pierre Fayad, Mojtaba Akhtari

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background Central nervous system complications (CNSC) can be the cause of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aimed to determine the incidence of CNSC and its impact on survival. Patients and Methods This retrospective cohort study included patients with hematologic disorders who received allo-HSCT between 2002 and 2011 at the University of Nebraska Medical Center. Results Of the 351 patients identified, 45 developed CNSC (12.8%). The 100-day cumulative incidence of CNSC was 8% (95% confidence interval, 8-15). The most common CNSC included posterior reversible encephalopathy syndrome (40%), stroke or transient ischemic attack (24%), seizures (20%), and infection (9%). The 5-year overall survival was significantly lower among patients with versus without CNSC (14% vs. 44%, P =.0004). In multivariate analysis, the risk of mortality for patients with versus without CNSC was significantly higher (hazard ratio, 1.56; 95% confidence interval, 1.03-2.36; P =.04). Conclusion The occurrence of CNSC after allo-HSCT was associated with reduced survival. Identifying patients at risk, monitoring, early detection, and management of CNSC after allo-HSCT are needed to improve outcomes.

Original languageEnglish (US)
Pages (from-to)606-611
Number of pages6
JournalClinical Lymphoma, Myeloma and Leukemia
Volume15
Issue number10
DOIs
StatePublished - Oct 1 2015

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Central nervous system complications
  • Posterior reversible encephalopathy syndrome
  • Seizure
  • Stroke
  • Survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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