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024 | 7 | _ | |a 2666-6367 |2 ISSN |
037 | _ | _ | |a DKFZ-2024-00581 |
041 | _ | _ | |a English |
082 | _ | _ | |a 610 |
100 | 1 | _ | |a Sala, Elisa |b 0 |
245 | _ | _ | |a Neurologic Complications of the Central Nervous System after Allogeneic Stem Cell Transplantation: The Role of Transplantation-Associated Thrombotic Microangiopathy as a Potential Underreported Cause. |
260 | _ | _ | |a [Amsterdam] |c 2024 |b Elsevier B. V. |
336 | 7 | _ | |a article |2 DRIVER |
336 | 7 | _ | |a Output Types/Journal article |2 DataCite |
336 | 7 | _ | |a Journal Article |b journal |m journal |0 PUB:(DE-HGF)16 |s 1717408521_4832 |2 PUB:(DE-HGF) |
336 | 7 | _ | |a ARTICLE |2 BibTeX |
336 | 7 | _ | |a JOURNAL_ARTICLE |2 ORCID |
336 | 7 | _ | |a Journal Article |0 0 |2 EndNote |
500 | _ | _ | |a 2024 Jun;30(6):586.e1-586.e11 |
520 | _ | _ | |a 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. |
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650 | _ | 7 | |a allogeneic stem cell transplantation |2 Other |
650 | _ | 7 | |a neurological complications |2 Other |
650 | _ | 7 | |a tacrolimus |2 Other |
650 | _ | 7 | |a transplantation-associated thrombotic microangiopathy |2 Other |
700 | 1 | _ | |a Neagoie, Adela M |b 1 |
700 | 1 | _ | |a Lewerenz, Jan |b 2 |
700 | 1 | _ | |a Saadati, Maral |0 P:(DE-He78)609d3f1c1420bf59b2332eeab889cb74 |b 3 |u dkfz |
700 | 1 | _ | |a Benner, Axel |0 P:(DE-He78)e15dfa1260625c69d6690a197392a994 |b 4 |u dkfz |
700 | 1 | _ | |a Gantner, Andrea |b 5 |
700 | 1 | _ | |a Wais, Verena |b 6 |
700 | 1 | _ | |a Döhner, Hartmut |b 7 |
700 | 1 | _ | |a Bunjes, Donald |b 8 |
773 | _ | _ | |a 10.1016/j.jtct.2024.03.017 |g p. S2666636724002902 |0 PERI:(DE-600)3056525-X |n 6 |p 586.e1-586.e11 |t Transplantation and cellular therapy |v 30 |y 2024 |x 2666-6375 |
856 | 4 | _ | |u https://inrepo02.dkfz.de/record/289081/files/1-s2.0-S2666636724002902-main.pdf |
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