Document Detail

Long-term outcomes of allogeneic stem cell transplant recipients after calcineurin inhibitor-induced neurotoxicity.
MedLine Citation:
PMID:  14510951     Owner:  NLM     Status:  MEDLINE    
Calcineurin inhibitor-induced central nervous system toxicities are uncommon and often resolve after discontinuation of the offending drug. The long-term outcome of these patients is, however, unknown. Resolution of symptoms occurred in 70% of 30 allografted recipients who developed calcineurin inhibitor-induced neurotoxicity. When patients were rechallenged with the same or a different calcineurin inhibitor, symptoms recurred in 41%, leading to permanent discontinuation of the drug. De novo or progressive acute graft-versus-host disease (GVHD) was observed in 54% of patients at a median of 7 d (range 1-70 d) after initial onset of neurotoxicity. The prognosis was grim, with 24 (80%) of these patients dying a median 33 d after the onset of neurotoxicity (range 2-594 d). GVHD and/or infection occurred in 54% and were the most common primary causes of death. We conclude that calcineurin inhibitor-induced neurotoxicity is frequently reversible but associated with a poor prognosis.
Rizwana Chohan; Ravi Vij; Douglas Adkins; William Blum; Randy Brown; Michael Tomasson; Steven Devine; Timothy Graubert; Lawrence T Goodnough; John F DiPersio; Hanna Khoury
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of haematology     Volume:  123     ISSN:  0007-1048     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-26     Completed Date:  2003-11-10     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  110-3     Citation Subset:  IM    
Washington University School of Medicine, Department of Medicine, Division of Oncology, Section of Leukaemia & Bone Marrow Transplantation, St Louis, MO 63110-1093, USA.
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MeSH Terms
Bone Marrow Diseases / mortality,  surgery*
Bone Marrow Transplantation
Brain / pathology
Calcineurin / antagonists & inhibitors*
Central Nervous System Diseases / chemically induced*,  mortality,  pathology
Cyclosporine / adverse effects,  therapeutic use
Graft vs Host Disease / mortality,  prevention & control
Hematopoietic Stem Cell Transplantation*
Immunosuppressive Agents / adverse effects*,  therapeutic use
Magnetic Resonance Imaging
Methotrexate / adverse effects,  therapeutic use
Middle Aged
Prednisone / adverse effects,  therapeutic use
Retrospective Studies
Tacrolimus / adverse effects,  therapeutic use
Transplantation, Homologous
Reg. No./Substance:
0/Immunosuppressive Agents; 109581-93-3/Tacrolimus; 53-03-2/Prednisone; 59-05-2/Methotrexate; 59865-13-3/Cyclosporine; EC

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