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Erschienen in: International Journal of Hematology 5/2019

12.03.2019 | Original Article

Cerebrovascular disease after allogeneic hematopoietic stem cell transplantation: incidence, risk, and clinical outcome

verfasst von: Ting-An Lin, Jyh-Pyng Gau, Yao-Chung Liu, Po-Shen Ko, Hao-Yuan Wang, Sheng-Hsuan Chien, Chia-Jen Liu, Liang-Tsai Hsiao, Tzeon-Jye Chiou, Jin-Hwang Liu

Erschienen in: International Journal of Hematology | Ausgabe 5/2019

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Abstract

Cerebrovascular complications after hematopoietic stem cell transplantation (HSCT) cause serious morbidity and often contribute to mortality. The incidence, risk factors, and outcome of cerebrovascular disease (CVD) after allogeneic HSCT remain poorly defined. We retrospectively evaluated 459 adult patients who underwent allogeneic HSCT at a tertiary medical center between January 2003 and December 2015. A total of 20 patients (4.4%) developed post-transplant CVD. All cerebrovascular accidents occurred in the first two years post-transplant. The two-year incidences of post-transplant CVD, intracranial hemorrhage, and cerebrovascular infarction were 6.1%, 3.2%, and 3.2%, respectively. The incidence rate of CVD within two years after HSCT was 34.7 (95% CI 22.3 to − 53.7) per 1000 person-years, which was about tenfold higher than the general Taiwanese population. The only significant risk factor associated with post-transplant CVD is prior exposure to three or more courses of high-dose cytarabine. Post-transplant CVD is associated with dismal outcome and early mortality. The median overall survival of patients with post-transplant CVD was markedly reduced compared with those without CVD (8.0 vs. 60.6 months). Most patients with post-transplant CVD died within two months after the CVD events. Our study demonstrates that CVD remains a devastating complication after allogeneic HSCT in the modern era.
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Metadaten
Titel
Cerebrovascular disease after allogeneic hematopoietic stem cell transplantation: incidence, risk, and clinical outcome
verfasst von
Ting-An Lin
Jyh-Pyng Gau
Yao-Chung Liu
Po-Shen Ko
Hao-Yuan Wang
Sheng-Hsuan Chien
Chia-Jen Liu
Liang-Tsai Hsiao
Tzeon-Jye Chiou
Jin-Hwang Liu
Publikationsdatum
12.03.2019
Verlag
Springer Japan
Erschienen in
International Journal of Hematology / Ausgabe 5/2019
Print ISSN: 0925-5710
Elektronische ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-019-02624-y

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