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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
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
2013-03-20
DOI10.3760/cma.j.issn.0366-6999.20120988
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
WOS记录号WOS:000319783700018
项目编号81070449 ; 7112139 ; 2012BAI38B03 ; Z111107058811024
资助机构National Natural Science Foundation of China ; National Science Foundation of Beijing ; National Key Technology Support Program ; Capital Clinical Characteristic Application Foundation
引用统计
被引频次:6[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/64400
专题北京大学第二临床医学院_血液科
医学人文研究院/公共教学部_哲学与社会科学系
北京大学第一临床医学院_医学统计室
作者单位Peking Univ, Peoples Hosp, Inst Hematol, Beijing 100044, Peoples R China
推荐引用方式
GB/T 7714
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.
APA Zhang Xiao-hui.,Huang Xiao-jun.,Liu Kai-yan.,Xu Lan-ping.,Liu Dai-hong.,...&Wang Min.(2013).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.CHINESE MEDICAL JOURNAL,126(6),1096-1102.
MLA Zhang Xiao-hui,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".CHINESE MEDICAL JOURNAL 126.6(2013):1096-1102.
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