Retrospective analysis of posterior reversible encephalopathy syndrome after allogeneic stem cell transplantation

Yoshinobu Aisa, Takehiko Mori, Takayuki Shimizu, Yuiko Tsukada, Jun Kato, Shigeaki Suzuki, Norihiro Suzuki, Yasuo Ikeda, Shinichiro Okamoto

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Posterior reversible encephalopathy syndrome (PRES) is one of the serious adverse side effects of calcineurin inhibitors, which are used for the prophylaxis of graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT). We retrospectively analyzed 12 patients who developed PRES after allo-SCT aiming to clarify the clinical features, risk factors, and prognosis of PRES. Median onset of PRES is 17 days after allo-SCT. The most frequent primary symptom was high blood pressure, followed by headache and visual disturbance. Nine of our patients subsequently developed systemic seizure. Sites of PRES by MRI were detected in the frontal, temporal, and parietal lobes, basal ganglia, and brain stem in addition to occipital lobe. Serum creatinine that had increased two-fold from the baseline value was identified as the only risk factor for developing PRES after allo-SCT. The incidence of acute GVHD (grade II-IV) in patients with PRES and those without were 88.9% and 48.7%; respectively (P<0.001), and most of these patients died of GVHD or GVHD-related causes. The 2-year overall survival of patients with PRES and those without were 16.7% and 72.4%, respectively (P<0.001). These data suggested the importance of early intervention for PRES and exploitation of optimal GVHD prophylaxis after developing PRES.

Original languageEnglish
Pages (from-to)9-15
Number of pages7
Journal[Rinshō ketsueki] The Japanese journal of clinical hematology
Volume50
Issue number1
Publication statusPublished - 2009 Jan

Fingerprint

Posterior Leukoencephalopathy Syndrome
Stem Cell Transplantation
Graft vs Host Disease
Occipital Lobe
Parietal Lobe
Frontal Lobe
Temporal Lobe
Basal Ganglia
Brain Stem
Headache
Creatinine
Seizures

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{26e98017460f4045b56dcc2f87abc9ff,
title = "Retrospective analysis of posterior reversible encephalopathy syndrome after allogeneic stem cell transplantation",
abstract = "Posterior reversible encephalopathy syndrome (PRES) is one of the serious adverse side effects of calcineurin inhibitors, which are used for the prophylaxis of graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT). We retrospectively analyzed 12 patients who developed PRES after allo-SCT aiming to clarify the clinical features, risk factors, and prognosis of PRES. Median onset of PRES is 17 days after allo-SCT. The most frequent primary symptom was high blood pressure, followed by headache and visual disturbance. Nine of our patients subsequently developed systemic seizure. Sites of PRES by MRI were detected in the frontal, temporal, and parietal lobes, basal ganglia, and brain stem in addition to occipital lobe. Serum creatinine that had increased two-fold from the baseline value was identified as the only risk factor for developing PRES after allo-SCT. The incidence of acute GVHD (grade II-IV) in patients with PRES and those without were 88.9{\%} and 48.7{\%}; respectively (P<0.001), and most of these patients died of GVHD or GVHD-related causes. The 2-year overall survival of patients with PRES and those without were 16.7{\%} and 72.4{\%}, respectively (P<0.001). These data suggested the importance of early intervention for PRES and exploitation of optimal GVHD prophylaxis after developing PRES.",
author = "Yoshinobu Aisa and Takehiko Mori and Takayuki Shimizu and Yuiko Tsukada and Jun Kato and Shigeaki Suzuki and Norihiro Suzuki and Yasuo Ikeda and Shinichiro Okamoto",
year = "2009",
month = "1",
language = "English",
volume = "50",
pages = "9--15",
journal = "[Rinshō ketsueki] The Japanese journal of clinical hematology",
issn = "0485-1439",
publisher = "Nihon Rinsho Ketsueki Gakkai/Japan Society of Clinical Hematology",
number = "1",

}

TY - JOUR

T1 - Retrospective analysis of posterior reversible encephalopathy syndrome after allogeneic stem cell transplantation

AU - Aisa, Yoshinobu

AU - Mori, Takehiko

AU - Shimizu, Takayuki

AU - Tsukada, Yuiko

AU - Kato, Jun

AU - Suzuki, Shigeaki

AU - Suzuki, Norihiro

AU - Ikeda, Yasuo

AU - Okamoto, Shinichiro

PY - 2009/1

Y1 - 2009/1

N2 - Posterior reversible encephalopathy syndrome (PRES) is one of the serious adverse side effects of calcineurin inhibitors, which are used for the prophylaxis of graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT). We retrospectively analyzed 12 patients who developed PRES after allo-SCT aiming to clarify the clinical features, risk factors, and prognosis of PRES. Median onset of PRES is 17 days after allo-SCT. The most frequent primary symptom was high blood pressure, followed by headache and visual disturbance. Nine of our patients subsequently developed systemic seizure. Sites of PRES by MRI were detected in the frontal, temporal, and parietal lobes, basal ganglia, and brain stem in addition to occipital lobe. Serum creatinine that had increased two-fold from the baseline value was identified as the only risk factor for developing PRES after allo-SCT. The incidence of acute GVHD (grade II-IV) in patients with PRES and those without were 88.9% and 48.7%; respectively (P<0.001), and most of these patients died of GVHD or GVHD-related causes. The 2-year overall survival of patients with PRES and those without were 16.7% and 72.4%, respectively (P<0.001). These data suggested the importance of early intervention for PRES and exploitation of optimal GVHD prophylaxis after developing PRES.

AB - Posterior reversible encephalopathy syndrome (PRES) is one of the serious adverse side effects of calcineurin inhibitors, which are used for the prophylaxis of graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT). We retrospectively analyzed 12 patients who developed PRES after allo-SCT aiming to clarify the clinical features, risk factors, and prognosis of PRES. Median onset of PRES is 17 days after allo-SCT. The most frequent primary symptom was high blood pressure, followed by headache and visual disturbance. Nine of our patients subsequently developed systemic seizure. Sites of PRES by MRI were detected in the frontal, temporal, and parietal lobes, basal ganglia, and brain stem in addition to occipital lobe. Serum creatinine that had increased two-fold from the baseline value was identified as the only risk factor for developing PRES after allo-SCT. The incidence of acute GVHD (grade II-IV) in patients with PRES and those without were 88.9% and 48.7%; respectively (P<0.001), and most of these patients died of GVHD or GVHD-related causes. The 2-year overall survival of patients with PRES and those without were 16.7% and 72.4%, respectively (P<0.001). These data suggested the importance of early intervention for PRES and exploitation of optimal GVHD prophylaxis after developing PRES.

UR - http://www.scopus.com/inward/record.url?scp=64849087039&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=64849087039&partnerID=8YFLogxK

M3 - Article

VL - 50

SP - 9

EP - 15

JO - [Rinshō ketsueki] The Japanese journal of clinical hematology

JF - [Rinshō ketsueki] The Japanese journal of clinical hematology

SN - 0485-1439

IS - 1

ER -