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Clinical characteristics and risk factors of Intracranial hemorrhage in patients following allogeneic hematopoietic stem cell transplantation.
- Source :
- Annals of Hematology; Oct2016, Vol. 95 Issue 10, p1637-1643, 7p
- Publication Year :
- 2016
-
Abstract
- Intracranial hemorrhage (ICH) is one of the most life-threatening neurological complications after allogeneic hematopoietic stem cell transplantation. Although cerebral complications and its causes after allo-HSCT are well documented, assessment of the incidence and risk factors of intracranial hemorrhage following allo-HSCT are less discussed. A nested case-control study was conducted involving 160 subjects drawn from 2169 subjects who underwent HSCT at Peking University People's Hospital between 2004 and 2014. Thirty-two patients (1.5 %) with ICH were identified, and 128 controls were matched for age, gender, transplantation type, and time of transplantation. Intracranial hemorrhage was identified by CT scan and/or MRI by searching hospital records. Among the 32 ICH patients, 27 (82.9 %) developed intraparenchymal hemorrhages (IPH), 2 cases (5.7 %) suffered subdural hematomas (SDH), and 3 cases (8.6 %) had multiple hemorrhage lesions in the brain parenchyma. The median time of appearance for cerebral hemorrhages was 147.5 days. Multivariate analysis showed that systemic infections (hazard ratio 2.882, 95 % confidence interval 1.231-6.746), platelet count (5.894, 1.145-30.339), and fibrinogen levels (3.611, 1.528-8.532) were independent risk factors for intracranial hemorrhage among HSCT patients. The cumulative survival rate in the intracranial hemorrhage and control groups were 43.3 and 74.7 % (Pā=ā.001), respectively. Intracranial hemorrhage is associated with high mortality and a decreased overall survival rate. Systemic infections, platelet count, and fibrinogen levels were individual independent risk factors. [ABSTRACT FROM AUTHOR]
- Subjects :
- INTRACRANIAL hematoma
HEMORRHAGE
HOMOGRAFTS
STEM cell transplantation
BLOOD platelets
APLASTIC anemia treatment
GRAFT versus host disease prevention
HEMATOLOGIC malignancies
CEREBRAL hemorrhage
SEIZURES (Medicine)
FIBRINOGEN
HEMATOPOIETIC stem cell transplantation
IMMUNOSUPPRESSION
IMMUNOSUPPRESSIVE agents
INFECTION
SPASMS
SUBDURAL hematoma
SURVIVAL
RETROSPECTIVE studies
CASE-control method
KAPLAN-Meier estimator
PLATELET count
DISEASE complications
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 09395555
- Volume :
- 95
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Annals of Hematology
- Publication Type :
- Academic Journal
- Accession number :
- 117417619
- Full Text :
- https://doi.org/10.1007/s00277-016-2767-y