Neurologic complications after allogeneic marrow transplantation for sickle cell anemia.

Published

Journal Article

Seven of 21 patients with sickle cell anemia developed neurologic complications 5 to 243 days (median, 33 days) after allogeneic marrow transplantation. Among these 7 patients, indications for transplantation included either a past history of stroke (4 patients) or recurrent severe vaso-occlusive events (3 patients). All received marrow from an HLA-identical sibling after preparation with busulfan and cyclophosphamide, and in 4 patients with antithymocyte globulin. Five of 6 patients developing seizures received anticonvulsant and supportive treatment with resolution of neurologic abnormalities. Three patients experienced intracranial bleeding, which was fatal in two. Of the 14 patients free of neurologic complications, 4 patients had experienced stroke before transplantation. However, among all patients with prior stroke, the incidence of intracranial hemorrhage was 38% (3/8), whereas none of the 13 patients without prior stroke developed posttransplant intracranial bleeding (P = .026). We conclude that patients with sickle cell anemia are at increased risk for neurologic complications after marrow ablative therapy and that patients with prior stroke are at increased risk for intracranial hemorrhage. Transplantation of patients before the onset of overt stroke may reduce this risk.

Full Text

Duke Authors

Cited Authors

  • Walters, MC; Sullivan, KM; Bernaudin, F; Souillet, G; Vannier, JP; Johnson, FL; Lenarsky, C; Powars, D; Bunin, N; Ohene-Frempong, K

Published Date

  • February 15, 1995

Published In

Volume / Issue

  • 85 / 4

Start / End Page

  • 879 - 884

PubMed ID

  • 7849310

Pubmed Central ID

  • 7849310

International Standard Serial Number (ISSN)

  • 0006-4971

Language

  • eng

Conference Location

  • United States