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000289081 1001_ $$aSala, Elisa$$b0
000289081 245__ $$aNeurologic Complications of the Central Nervous System after Allogeneic Stem Cell Transplantation: The Role of Transplantation-Associated Thrombotic Microangiopathy as a Potential Underreported Cause. 
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000289081 520__ $$aneurological complications (NC), especially those of the central nervous system (CNS), represent a severe complication after allogeneic stem cell transplantation (allo-HSCT) and are associated with relevant morbidity and mortality.we aim to characterize the potential risk factors for the development of CNS-NC with a special focus on the role of calcineurin inhibitors (CNI) as a predisposing factor. For this purpose, we compared Cyclosporin A (CsA) versus Tacrolimus (TAC) with respect to their influence on the incidence and type of CNS-NC after allo-HSCT.we retrospectively analyzed incidence, risk factors and impact on outcome of CNS-NC diagnosed during the post-transplantation follow-up in patients with different high-risk hematological malignancies who underwent allo-HSCT at our institution over a time frame of 20 years. All patients included in the analysis received CNI (CsA or TAC) as graft versus host disease (GVHD) prophylaxis.we evaluated a total of 739 consecutive patients transplanted from 12/1999 to 04/2019. Within a median follow-up period of 6.8 years, we observed a CNS-NC incidence of 17%. The development of CNS-NC was associated with decreased overall survival (OS) and increased transplant-related mortality (TRM). The most frequent CNS-NC were infections (30%) and neurological adverse events related to the administration of CNI, TAC or CsA, as GVHD prophylaxis (42%). In the multivariable analysis, age, total body irradiation (TBI) and severe acute and chronic GVHD significantly impacted as risk factors on the development of CNS-NC. TAC as compared with CsA emerged as an independent predisposing factor for CNS-NC. The TAC-associated risk of CNS-NC was mostly due to the occurrence of transplant-associated thrombotic microangiopathy (TA-TMA) with neurological manifestations (Neuro-TA-TMA), even if the general TA-TMA incidence was comparable in the two CNI subgroups.CNS-NC are associated with poor prognosis after allo-HSCT with TAC emerging as a potential yet insufficiently characterized predisposing factor.
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000289081 650_7 $$2Other$$aallogeneic stem cell transplantation
000289081 650_7 $$2Other$$aneurological complications
000289081 650_7 $$2Other$$atacrolimus
000289081 650_7 $$2Other$$atransplantation-associated thrombotic microangiopathy
000289081 7001_ $$aNeagoie, Adela M$$b1
000289081 7001_ $$aLewerenz, Jan$$b2
000289081 7001_ $$0P:(DE-He78)609d3f1c1420bf59b2332eeab889cb74$$aSaadati, Maral$$b3$$udkfz
000289081 7001_ $$0P:(DE-He78)e15dfa1260625c69d6690a197392a994$$aBenner, Axel$$b4$$udkfz
000289081 7001_ $$aGantner, Andrea$$b5
000289081 7001_ $$aWais, Verena$$b6
000289081 7001_ $$aDöhner, Hartmut$$b7
000289081 7001_ $$aBunjes, Donald$$b8
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