中国神经再生研究(英文版) ›› 2018, Vol. 13 ›› Issue (6): 945-954.doi: 10.4103/1673-5374.233431

• 综述:神经损伤修复保护与再生 • 上一篇    下一篇

儿童及成年的造血细胞移植导致的神经并发症

  

  • 收稿日期:2018-04-25 出版日期:2018-06-15 发布日期:2018-06-15

Neurological complications of hematopoietic cell transplantation in children and adults

Adriana Octaviana Dulamea1, 2, Ioana Gabriela Lupescu1, 3   

  1. 1 University of Medicine and Pharmacy Carol Davila, Bucharest, Romania;
    2 Department of Neurology, Fundeni Clinical Institute, Bucharest, Romania;
    3 Radiology and Medical Imaging Department, Fundeni Clinical Institute, Bucharest, Romania
  • Received:2018-04-25 Online:2018-06-15 Published:2018-06-15
  • Contact: Adriana Octaviana Dulamea,Ph.D., Associate Professor of Neurology at University of Medicine and Pharmacy Carol Davila Bucharest, Head of Neurology Department Fundeni Clinical Institute,adrianadulamea@gmail.com.

摘要:

orcid:0000-0002-5056-0191(Adriana Octaviana Dulamea)

Abstract:

Hematopoietic cell transplantation (HCT) is widely performed for neoplastic and non-neoplastic diseases. HCT involves intravenous infusion of hematopoietic progenitor cells from human leukocyte antigen (HLA)-matched donor (allogeneic) or from the patient (autologous). Before HCT, the patient is prepared with high dose chemotherapy and/or radiotherapy to destroy residual malignant cells and to reduce immunologic resistance. After HCT, chemotherapy is used to prevent graft rejection and graft versus host disease (GvHD). Neurological complications are related to the type of HCT, underlying disease, toxicity of the conditioning regimens, immunosuppression caused by conditioning regimens, vascular complications generated by thrombocytopenia and/or coagulopathy, GvHD and inappropriate immune response. In this review, neurological complications are presented according to time of onset after HCT: (1) early complications (in the first month) - related to harvesting of stem cells, during conditioning (drug toxicity, posterior reversible encephalopathy syndrome), related to pancytopenia, (2) intermediate phase complications (second to sixth month) - central nervous system infections caused by prolonged neutropenia and progressive multifocal leukoencephalopathy due to JC virus, (3) late phase complications (after sixth month) - neurological complications of GvHD, second neoplasms and relapses of the original disease.

Key words: neurological complications, hematopoietic cell transplantation, posterior reversible encephalopathy syndrome, central nervous system infections, progressive multifocal leukoencephalopathy, graft versus host disease, second neoplasm, immune reconstitution inflammatory syndrome, post-transplant acute limbic encephalitis, drug reaction with eosinophilia and systemic symptoms