Clinical study of the nervous system complications after hematopoietic stem cell transplantation
10.12025/j.issn.1008-6358.2016.20160604
- VernacularTitle:造血干细胞移植后神经系统并发症的临床分析
- Author:
Zhou YIN
1
;
Ping ZHANG
;
Ying ZHANG
;
Xiao-Wen TANG
;
Zheng-Zheng FU
;
Feng CHEN
;
Sheng-Li XUE
;
Zi-Qiang YU
;
Ai-Ning SUN
;
De-Pei WU
;
Wan-Li DONG
;
Qun XUE
Author Information
1. 苏州大学附属第一医院神经内科
- Keywords:
hematopoietic stem cell transplantation;
nervous system complications;
risk factors
- From:
Chinese Journal of Clinical Medicine
2016;23(6):776-781
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Analyze the characteristics of nervous system (NS)complications after hematopoietic stem cell transplantation(HSCT ) ,and evaluate risk factors in order to reduce its occurrence ,provide better diagnosis and treatment and improve the prognosis of the patients .Methods:The clinical outcomes of the patients who developed NS complications after HSCT were collected in our hospital from August 2012 to August 2015 ,and retrospective analysis was used .Results:A total of 87 patients with NS complications after HSCT include central nervous system complications was 71 .3% (62/87 ) and peripheral nerve complications was 28 .7% (25/87) . The types of primary disease included acute lymphoblastic leukemia (ALL)34 .5% (30/87) ,acute myelogenous leukemia (AML)23 .0% (20/87) ,chronic myelogenous leukemia (CML )12 .6%(11/87) ,other types of leukemia by 9 .2% (8/87) ,aplastic anemia 13 .8% (12/87) ,myelodysplastic syndrome 6 .9% (6/87);HLA matched 19 cases (21 .8% ) ,HLA mismatched 53 cases (60 .9% ) ,unrelated donors 15 cases (17 .2% ) ,central nervous system complication rate was 16 .1% ,69 .4% and 14 .5% , respectively ;peripheral nerve complication rate was 36 .0% , 40 .0% and 24 .0% respectively (χ2 =6 .682 ,P=0 .034) .The incidences of NS complications were 26 .4% (23/87) in children and 73 .6% (64/87)in adults respectively ,and there was no significant difference in the types of NS complications (P=0 .435) . The cases accompanied with GVHD or infection respectively account for 69 .0% (60/87) and 59 .8% (52/87) ,and there were significant difference in the incidences of types of NS complications (P< 0 .05) .The onset time of 87 patients with nervous system complications or peripheral nerve complications was 1‐726 days (median 49 days) and 20‐694 days (median 80 days) , respectively .The overall mortality rate was 33 .3% (29/87) ,with central nervous system complications was 93 .1% (27/29) , with peripheral nerve complications was 6 .9% (2/29 , P< 0 .05) .Conclusions :The patients with central nervous system complications have higher incidence , higher mortality ,and shorter onset time than the patients with peripheral nerve complications ,and related with HLA types ,GVHD and infection risk factors .
