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- Publisher Website: 10.1007/s00381-021-05235-3
- Scopus: eid_2-s2.0-85115213729
- PMID: 34546410
- WOS: WOS:000698026100002
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Article: Neurological complications in Chinese children undergoing hematopoietic stem cell transplantation
Title | Neurological complications in Chinese children undergoing hematopoietic stem cell transplantation |
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Authors | |
Keywords | Hematopoietic stem cell transplantation Neurological complications Posterior reversible encephalopathy syndrome Total body irradiation Transplant-related morbidity |
Issue Date | 2021 |
Publisher | Springer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00381/index.htm |
Citation | Child's Nervous System, 2021, Epub 2021-09-21 How to Cite? |
Abstract | Background: Hematopoietic stem cell transplantation, despite being a curative treatment for various pediatric disorders, is associated with significant acute and chronic complications.
Methods: This retrospective review of 196 hematopoietic stem cell transplantation episodes (144 allogeneic, 52 autologous) performed in a tertiary pediatric unit focused on neurological symptoms and complications occurred from the start of conditioning to within 3 years of transplantation. Indications for transplantation included both benign and malignant diseases. For episodes involving allogeneic transplantation, 42% of donors were matched-unrelated, 19% were matched-sibling, and 12% were haploidentical. RESULTS: Neurological complications developed in 17% of all hematopoietic stem cell transplantation episodes. Tumors of central nervous system and leukemia or lymphoma were two indications reported to have higher incidence of 42% and 21%, respectively. The occurrence of neurological complications was significantly associated with primary diagnosis (p = 0.01), central nervous system involvement by underlying disease (p = 0.001), and radiation-based conditioning (p = 0.018). Upon multivariate analysis, central nervous system involvement by underlying disease remained to be the only significant factor (p = 0.019), while radiation-based containing conditioning (p = 0.029) is revealed to be associated when considering allogeneic transplantation alone. Pre-transplant central nervous system-directed treatment, allogeneic versus autologous donor, stem cell source, donor type, busulfan use, and cyclosporin use were not significantly associated with neurological complications. Patients with neurological complications were also found to have an inferior 2-year overall survival (53.9% ± 8.8% versus 63.8% ± 4.2%; p = 0.016).
Conclusion: Neurological complications were common in pediatric hematopoietic stem cell transplantation and were associated with adverse outcome; non-radiation containing conditioning regimens might be beneficial in mitigating the risk of such complications. |
Persistent Identifier | http://hdl.handle.net/10722/306878 |
ISSN | 2023 Impact Factor: 1.3 2023 SCImago Journal Rankings: 0.518 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Mak, CYK | - |
dc.contributor.author | Cheuk, DKL | - |
dc.contributor.author | Lee, PPW | - |
dc.contributor.author | Chiang, AKS | - |
dc.contributor.author | Ha, SY | - |
dc.contributor.author | Liu, APY | - |
dc.contributor.author | Chan, GCF | - |
dc.date.accessioned | 2021-10-22T07:40:54Z | - |
dc.date.available | 2021-10-22T07:40:54Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | Child's Nervous System, 2021, Epub 2021-09-21 | - |
dc.identifier.issn | 0256-7040 | - |
dc.identifier.uri | http://hdl.handle.net/10722/306878 | - |
dc.description.abstract | Background: Hematopoietic stem cell transplantation, despite being a curative treatment for various pediatric disorders, is associated with significant acute and chronic complications. Methods: This retrospective review of 196 hematopoietic stem cell transplantation episodes (144 allogeneic, 52 autologous) performed in a tertiary pediatric unit focused on neurological symptoms and complications occurred from the start of conditioning to within 3 years of transplantation. Indications for transplantation included both benign and malignant diseases. For episodes involving allogeneic transplantation, 42% of donors were matched-unrelated, 19% were matched-sibling, and 12% were haploidentical. RESULTS: Neurological complications developed in 17% of all hematopoietic stem cell transplantation episodes. Tumors of central nervous system and leukemia or lymphoma were two indications reported to have higher incidence of 42% and 21%, respectively. The occurrence of neurological complications was significantly associated with primary diagnosis (p = 0.01), central nervous system involvement by underlying disease (p = 0.001), and radiation-based conditioning (p = 0.018). Upon multivariate analysis, central nervous system involvement by underlying disease remained to be the only significant factor (p = 0.019), while radiation-based containing conditioning (p = 0.029) is revealed to be associated when considering allogeneic transplantation alone. Pre-transplant central nervous system-directed treatment, allogeneic versus autologous donor, stem cell source, donor type, busulfan use, and cyclosporin use were not significantly associated with neurological complications. Patients with neurological complications were also found to have an inferior 2-year overall survival (53.9% ± 8.8% versus 63.8% ± 4.2%; p = 0.016). Conclusion: Neurological complications were common in pediatric hematopoietic stem cell transplantation and were associated with adverse outcome; non-radiation containing conditioning regimens might be beneficial in mitigating the risk of such complications. | - |
dc.language | eng | - |
dc.publisher | Springer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00381/index.htm | - |
dc.relation.ispartof | Child's Nervous System | - |
dc.rights | This is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: https://doi.org/[insert DOI] | - |
dc.subject | Hematopoietic stem cell transplantation | - |
dc.subject | Neurological complications | - |
dc.subject | Posterior reversible encephalopathy syndrome | - |
dc.subject | Total body irradiation | - |
dc.subject | Transplant-related morbidity | - |
dc.title | Neurological complications in Chinese children undergoing hematopoietic stem cell transplantation | - |
dc.type | Article | - |
dc.identifier.email | Cheuk, DKL: klcheuk@hkucc.hku.hk | - |
dc.identifier.email | Lee, PPW: ppwlee@hku.hk | - |
dc.identifier.email | Chiang, AKS: chiangak@hku.hk | - |
dc.identifier.email | Ha, SY: syha@hku.hk | - |
dc.identifier.email | Liu, APY: apyliu@hku.hk | - |
dc.identifier.email | Chan, GCF: gcfchan@hku.hk | - |
dc.identifier.authority | Lee, PPW=rp00462 | - |
dc.identifier.authority | Chiang, AKS=rp00403 | - |
dc.identifier.authority | Liu, APY=rp01357 | - |
dc.identifier.authority | Chan, GCF=rp00431 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1007/s00381-021-05235-3 | - |
dc.identifier.pmid | 34546410 | - |
dc.identifier.scopus | eid_2-s2.0-85115213729 | - |
dc.identifier.hkuros | 328939 | - |
dc.identifier.volume | Epub 2021-09-21 | - |
dc.identifier.isi | WOS:000698026100002 | - |
dc.publisher.place | Germany | - |