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学科主题: 临床医学
题名:
Idiopathic inflammatory demyelinating diseases of the central nervous system in patients following allogeneic hematopoietic stem cell transplantation: a retrospective analysis of incidence, risk factors and survival
作者: Zhang Xiao-hui; Huang Xiao-jun; Liu Kai-yan; Xu Lan-ping; Liu Dai-hong; Chen Huan; Han Wei; Chen Yu-hong; Wang Feng-rong; Wang Jing-zhi; Wang Yu; Zhao Ting; Chen Yao; Fu Hai-xia; Wang Min
关键词: hematopoietic stem cell transplantation ; idiopathic inflammatory demyelinating diseases ; central nervous system ; risk factors ; survival
刊名: CHINESE MEDICAL JOURNAL
发表日期: 2013-03-20
DOI: 10.3760/cma.j.issn.0366-6999.20120988
卷: 126, 期:6, 页:1096-1102
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: BONE-MARROW-TRANSPLANTATION ; PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY ; ACUTE DISSEMINATED ENCEPHALOMYELITIS ; VERSUS-HOST-DISEASE ; NEUROLOGICAL COMPLICATIONS ; MULTIPLE-SCLEROSIS ; ENCEPHALOPATHY ; INFECTION ; DIAGNOSIS ; CHILDREN
英文摘要:

Background Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapy for many hematological diseases, but there are many complications following allo-HSCT, among which neurological complications (NC) are one of the most commonly described ones. However, little is known about idiopathic inflammatory demyelinating diseases (IIDDs) of the central nervous system (CNS) in patients following allo-HSCT.

Methods A nested case-control study was conducted in a large cohort of 1365 patients, who underwent allo-HSCT at the Institute of Hematology and Peking University People′s Hospital, between January 2004 and December 2009, 36 patients of whom developed CNS IIDDs. Kaplan-Meier method, univariate and multivariate Cox regression were applied in our statistical analysis using SPSS 16.0.

Results The cumulative incidence of all cases of IIDDs at 6 years posttransplantation was 3.6%. Thirty-five patients (97.2%) suffered IIDDs after transplantation, 16 patients (44.4%) between day 0 to day 100 post-transplantation, 10 patients (27.8%) between day 100 to 1 year post-transplantation, and 9 patients (25.0%) 1 year post-transplantation. Multivariate regression analysis identified donor type (P=0.031), infection (P=0.009), and acute lymphatic leukemia (P=0.017) as independent risk factors for posttransplantation IIDDs. The median survival time of patients with IIDDs was 514 days after transplantation (95% CI: 223-805). Survival at 6 years was significantly lower in patients who developed the diseases compared to those who did not (26.6% vs. 73.5%, P <0.001). Of the 36 patients experiencing IIDDs, 58.3% (n=21) died. The causes of death were graft-versus-host disease (GVHD) (n=4), underlying disease relapse (n=3), infections (n=12), and other causes (n=2).

Conclusions IIDDs is an uncommon but serious complication of allo-HSCT, especially in patients with a primary diagnosis of acute lymphatic leukemia, mismatched transplants, and infections. Our study results indicate that patients with IIDDs tend toward a poor prognosis following allo-HSCT.

语种: 英语
所属项目编号: 81070449 ; 7112139 ; 2012BAI38B03 ; Z111107058811024
项目资助者: National Natural Science Foundation of China ; National Science Foundation of Beijing ; National Key Technology Support Program ; Capital Clinical Characteristic Application Foundation
WOS记录号: WOS:000319783700018
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64400
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Inst Hematol, Beijing 100044, Peoples R China

Recommended Citation:
Zhang Xiao-hui,Huang Xiao-jun,Liu Kai-yan,et al. Idiopathic inflammatory demyelinating diseases of the central nervous system in patients following allogeneic hematopoietic stem cell transplantation: a retrospective analysis of incidence, risk factors and survival[J]. CHINESE MEDICAL JOURNAL,2013,126(6):1096-1102.
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