% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Sala:289081, author = {E. Sala and A. M. Neagoie and J. Lewerenz and M. Saadati$^*$ and A. Benner$^*$ and A. Gantner and V. Wais and H. Döhner and D. Bunjes}, title = {{N}eurologic {C}omplications of the {C}entral {N}ervous {S}ystem after {A}llogeneic {S}tem {C}ell {T}ransplantation: {T}he {R}ole of {T}ransplantation-{A}ssociated {T}hrombotic {M}icroangiopathy as a {P}otential {U}nderreported {C}ause.}, journal = {Transplantation and cellular therapy}, volume = {30}, number = {6}, issn = {2666-6375}, address = {[Amsterdam]}, publisher = {Elsevier B. V.}, reportid = {DKFZ-2024-00581}, pages = {586.e1-586.e11}, year = {2024}, note = {2024 Jun;30(6):586.e1-586.e11}, abstract = {neurological 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.}, keywords = {allogeneic stem cell transplantation (Other) / neurological complications (Other) / tacrolimus (Other) / transplantation-associated thrombotic microangiopathy (Other)}, cin = {C060}, ddc = {610}, cid = {I:(DE-He78)C060-20160331}, pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)}, pid = {G:(DE-HGF)POF4-313}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:38508452}, doi = {10.1016/j.jtct.2024.03.017}, url = {https://inrepo02.dkfz.de/record/289081}, }