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Comparison of hemorrhagic and ischemic stroke after allogeneic hematopoietic stem cell transplantation.
Bone Marrow Transplant. 2020 Apr 24 [Online ahead of print]BM

Abstract

Stroke is an important complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Nevertheless, few studies have been published to analyzed the occurrence and prognosis of stroke after allo-HSCT. From January 2007 to December 2018 in Peking University People's Hospital, 6449 patients received HSCT and there were 2.3% of patients diagnosed with stroke after allo-HSCT (hemorrhagic: 1.0%, ischemic: 1.3%). The median time to hemorrhagic and ischemic stroke after HSCT was 161 days and 137 days, respectively. In total, 8.4% of patients experienced neurological sequelae. The outcome was much worse in patients with stroke than in control subjects. The comparison of prognosis showed no statistical differences between patients with hemorrhagic stroke and those with ischemic stroke. Significant risk factors for hemorrhagic stroke were pretransplant central nervous system leukemia (CNSL), and delayed platelet engraftment. Risk factors associated with the occurrence of ischemic stroke included high-risk disease, prior venous thromboembolism (VTE), grade III-IV acute graft-versus-host disease (aGVHD), and thrombotic microangiopathy (TMA). Haplo-identical transplantation was not a risk factor for stroke and had no impact on the prognosis compared with HLA-matched HSCT. Altogether, these results show that stroke is a severe complication after allo-HSCT. The prognosis of posttransplant stroke did not differ between hemorrhagic and ischemic stroke.

Authors+Show Affiliations

Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. zhangxiaohuirmyy@163.com. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. zhangxiaohuirmyy@163.com. Collaborative Innovation Center of Hematology, Peking University, Beijing, China. zhangxiaohuirmyy@163.com. National Clinical Research Center for Hematologic Disease, Beijing, China. zhangxiaohuirmyy@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32332920

Citation

Cai, Xuan, et al. "Comparison of Hemorrhagic and Ischemic Stroke After Allogeneic Hematopoietic Stem Cell Transplantation." Bone Marrow Transplantation, 2020.
Cai X, Fu HX, Mo XD, et al. Comparison of hemorrhagic and ischemic stroke after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2020.
Cai, X., Fu, H. X., Mo, X. D., Wang, Y., Zhang, Y. Y., Wu, J., Han, W., Tang, F. F., Gui, R. Y., Chen, H., Chen, Y., Zhao, P., Yan, C. H., Wang, J. Z., Chen, Y. H., Chang, Y. J., Xu, L. P., Liu, K. Y., Huang, X. J., & Zhang, X. H. (2020). Comparison of hemorrhagic and ischemic stroke after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplantation. https://doi.org/10.1038/s41409-020-0903-8
Cai X, et al. Comparison of Hemorrhagic and Ischemic Stroke After Allogeneic Hematopoietic Stem Cell Transplantation. Bone Marrow Transplant. 2020 Apr 24; PubMed PMID: 32332920.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of hemorrhagic and ischemic stroke after allogeneic hematopoietic stem cell transplantation. AU - Cai,Xuan, AU - Fu,Hai-Xia, AU - Mo,Xiao-Dong, AU - Wang,Yu, AU - Zhang,Yuan-Yuan, AU - Wu,Jin, AU - Han,Wei, AU - Tang,Fei-Fei, AU - Gui,Ruo-Yun, AU - Chen,Huan, AU - Chen,Yao, AU - Zhao,Peng, AU - Yan,Chen-Hua, AU - Wang,Jing-Zhi, AU - Chen,Yu-Hong, AU - Chang,Ying-Jun, AU - Xu,Lan-Ping, AU - Liu,Kai-Yan, AU - Huang,Xiao-Jun, AU - Zhang,Xiao-Hui, Y1 - 2020/04/24/ PY - 2019/12/31/received PY - 2020/04/03/accepted PY - 2020/04/01/revised PY - 2020/4/26/entrez JF - Bone marrow transplantation JO - Bone Marrow Transplant. N2 - Stroke is an important complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Nevertheless, few studies have been published to analyzed the occurrence and prognosis of stroke after allo-HSCT. From January 2007 to December 2018 in Peking University People's Hospital, 6449 patients received HSCT and there were 2.3% of patients diagnosed with stroke after allo-HSCT (hemorrhagic: 1.0%, ischemic: 1.3%). The median time to hemorrhagic and ischemic stroke after HSCT was 161 days and 137 days, respectively. In total, 8.4% of patients experienced neurological sequelae. The outcome was much worse in patients with stroke than in control subjects. The comparison of prognosis showed no statistical differences between patients with hemorrhagic stroke and those with ischemic stroke. Significant risk factors for hemorrhagic stroke were pretransplant central nervous system leukemia (CNSL), and delayed platelet engraftment. Risk factors associated with the occurrence of ischemic stroke included high-risk disease, prior venous thromboembolism (VTE), grade III-IV acute graft-versus-host disease (aGVHD), and thrombotic microangiopathy (TMA). Haplo-identical transplantation was not a risk factor for stroke and had no impact on the prognosis compared with HLA-matched HSCT. Altogether, these results show that stroke is a severe complication after allo-HSCT. The prognosis of posttransplant stroke did not differ between hemorrhagic and ischemic stroke. SN - 1476-5365 UR - https://www.unboundmedicine.com/medline/citation/32332920/Comparison_of_hemorrhagic_and_ischemic_stroke_after_allogeneic_hematopoietic_stem_cell_transplantation L2 - http://dx.doi.org/10.1038/s41409-020-0903-8 DB - PRIME DP - Unbound Medicine ER -
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