Seizures in children undergoing stem cell transplantation.

Autor: Turón-Viñas E; Child Neurology Unit, Pediatrics Service, Hospital Sant Pau, Barcelona, Spain.; Sant Pau Biomedical Research Institute, IIB Sant Pau, Barcelona, Spain., López-Torija I; Pediatric Hematology and Stem Cell Transplant Unit, Pediatrics Service, Hospital Sant Pau, Barcelona, Spain., Coca-Fernández E; Child Neurology Unit, Pediatrics Service, Hospital Sant Pau, Barcelona, Spain.; Sant Pau Biomedical Research Institute, IIB Sant Pau, Barcelona, Spain., Badell I; Sant Pau Biomedical Research Institute, IIB Sant Pau, Barcelona, Spain.; Pediatric Hematology and Stem Cell Transplant Unit, Pediatrics Service, Hospital Sant Pau, Barcelona, Spain., Sierra-Marcos A; Sant Pau Biomedical Research Institute, IIB Sant Pau, Barcelona, Spain.; Epilepsy Unit, Neurology Service, Hospital Sant Pau, Barcelona, Spain., Turón M; Child Neurology Unit, Pediatrics Service, Hospital Sant Pau, Barcelona, Spain.; Sant Pau Biomedical Research Institute, IIB Sant Pau, Barcelona, Spain., Ribosa-Nogué R; Sant Pau Biomedical Research Institute, IIB Sant Pau, Barcelona, Spain.; Epilepsy Unit, Neurology Service, Hospital Sant Pau, Barcelona, Spain., Boronat S; Child Neurology Unit, Pediatrics Service, Hospital Sant Pau, Barcelona, Spain.; Sant Pau Biomedical Research Institute, IIB Sant Pau, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2024 Feb; Vol. 28 (1), pp. e14619. Date of Electronic Publication: 2023 Oct 06.
DOI: 10.1111/petr.14619
Abstrakt: Background: Neurological complications (NCs) are of major concern following hematological stem cell transplantation (HSCT), most of which present with seizures.
Procedures: We performed a retrospective study (2002-2018) of patients undergoing HSCT in order to analyze the incidence and aetiologies related to seizures.
Results: Of 155 children undergoing HSCT, 27 (17.4%) developed seizures at some point in 2 years of follow-up. The most frequent etiologies were central nervous system (CNS) infection (n = 10), drug toxicity (n = 8), and vascular disease (n = 5). A statistically significant association was found between seizure and the HSCT type (lower risk for a related identical donor, p = .010), prophylactic or therapeutic mycophenolate use (p = .043 and .046, respectively), steroid use (p = .023), selective CD45RA+ depletion (p = .002), pre-engraftment syndrome (p = .007), and chronic graft-versus-host disease (GVHD) severity (p = .030). Seizures predicted evolution to life-threatening complications and admission to intensive care (p < .001) and higher mortality (p = .023). A statistically significant association was also found between seizures and sequelae in survivors (p = .029). Children who developed seizures had a higher risk of CNS infection and vascular disease (odds ratio 37.25 [95% CI: 7.45-186.05] and 12.95 [95% CI 2.24-74.80], respectively).
Conclusions: Neurological complications highly impact survival and outcomes and need to be addressed when facing an HSCT procedure.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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