Neurological complications after allogeneic hematopoietic stem cell transplantation in children, a single center experience

In this study, we retrospectively examined the data of children who underwent allo-HSCT from HLA-matched family donors. We analyzed the incidence, etiological factors, clinical characteristics, possible reasons, risk factors, and follow-up of neurologic complications. BU-based conditioning regimens were used in most of the cases (n=62). The median duration of follow-up for the 89 patients was 20months (range 1-41months). Eleven percent of transplanted children developed one or more neurological symptoms after HSCT with a median observation time of twomonths (range -6days to 18months). The median age of the four girls and six boys with neurological complication was 13yr (range 5.3-17.6yr). Cylosporine A neurotoxicity was diagnosed in five children, four of them were PRES. The rest of complications were BU and lorazepam toxicity, an intracranial hemorrhage, a sinovenous thrombosis, and a transient ischemic attack during extracorpereal photopheresis. No difference was found between groups of neurological complication according to age, gender, diagnosis, hospitalization time, neutrophil and platelet engraftment time, stem cell source, and conditioning regimen, acute and chronic GVHD or VOD. Neurological complication was the cause of death in one patient (1.1%).