Chapter

Neurological Complications of Hematopoietic Stem Cell Transplantation

DOI: 10.1007/978-1-59745-412-4_18

ABSTRACT Complications following hematopoietic stem cell transplantation have long been recognized. The causes are numerous, including
chemoradiotoxicity, medication toxicity, metabolic abnormalities, organ failure, graft versus host disease, infection, pancytopenia,
and platelet dysfunction. This chapter summarizes the disorders affecting the nervous system associated with hematopoietic
stem cell transplantation. As the number of transplants performed annually increases, potential neurologic complications are
being seen with increasing frequency.

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    ABSTRACT: The first successful transplants of hematopoietic stem cells were done in 1968 in three children with congenital immune deficiency diseases. In each instance, stem cells were collected from the bone marrow of sibling donors who were genotypically HLA identical or closely HLA matched to the recipient. Since then, thousands of patients have received hematopoietic stem cell transplants to treat malignant and non-malignant diseases. Current estimates of annual numbers of stem cell transplants are about 50,000 worldwide, with growth at a rate of 10-15% per year. The reasons for increasing use include proven and potential efficacy in many diseases, better understanding of the appropriate timing of transplantation and patient selection, greater availability of donors and better techniques for determining HLA match, greater ease of stem cell collection, and improved supportive care resulting in less transplant-related morbidity and mortality. About two-thirds of hematopoietic stem cell transplants use autologous cells, generally collected from peripheral blood by leukapheresis. The remainder are allogeneic transplants, most commonly from HLA-identical sibling donors, and most often using cells collected directly from bone marrow.
    International Journal of Hematology 09/2002; 76 Suppl 1:393-7. DOI:10.1007/BF03165291 · 1.68 Impact Factor
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    ABSTRACT: The retrospective study presented here reports clinical, electrophysiological and CT-data from 21 patients who underwent bone marrow transplantation for leukemia or aplastic anemia between 1980 and 1985. The aim of the investigation, which was performed at the end of 1986, was to elucidate whether antineoplastic drugs and radiation can result in long-term damage of the central nervous system. In 9 patients we observed neurological signs (1 leukencephalopathy, 5 cerebellar symptoms). Seven patients revealed dysrhythmia in the EEG and five had delayed latencies of visual evoked potentials. Eight patients exhibited pathological changes in CT (3 atrophy of supratentorial structures, 3 periventricular lucencies, 2 a combination of both). The results indicate that long-term damage to the CNS may be encountered after successful bone marrow transplantation.
    Der Nervenarzt 05/1991; 62(4):221-5. · 0.86 Impact Factor

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