Abstract Details

Title Incidence and Impact of Central Nervous System Complications on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation: A Single Center Experience

Topic Neuro-oncology

Presentation(s) P07 - (-)

Poster/Presentation
Number 006

Objective

Background BACKGROUND: Allogeneic hematopoietic stem cell transplantation (AHSCT) is commonly used for treating patients (pts) with hematological disorders. We present a retrospective review of central nervous system complications (CNSCs) in a cohort of pts with hematological disorders undergoing AHSCT, treated over a decade at a single institution.

Design/Methods DESIGN/METHODS: 351 pts with hematological disorders who received AHSCT between 2002 and 2011 at an academic medical center were identified through databases and medical records were reviewed for their neurologic complications. Comparisons between pts with or without CNSCs were performed. Cumulative incidence of having CNSCs was estimated using death as competing risk. Multivariate Cox proportional hazard regression analysis was used to compare mortality risk while adjusting for relevant prognostic factors.

Results RESULTS: From a cohort of 351 pts, 45 developed CNSCs (12.8%). No differences in baseline characterisitcs were noted between those with or without CNSCs. The 100-day cumulative incidence of CNSCs was 8% (95% confidence interval [CI] 8-15%). The most commonly observed CNSCs included: posterior reversible encephalopathy syndrome 18 (40%), stroke or TIA 11 (24%), seizures 9 (20%), and infection 4 (9%). In univariate analysis, there was a difference in overall survival (OS) according to CNSCs (log-rank p= 0.0002). The OS at 5 years for pts with CNSCs was 14% (3-32) vs. 44% for pts without CNSCs (p-value 0.0004). In multivariate analysis, CNSCs-associated risk of mortality was significantly higher, HR=1.56 (95% CI 1.03 - 2.36, p= 0.04). Prior history of high dose cytarabine was also associated with higher mortality, HR 2.19 (95% CI 1.51 - 3.18), p <0.0001.

Conclusions CONCLUSIONS: CNSCs after AHSCT are associated with reduced survival. Early identification of pts at risk, monitoring, early intervention and treatment for CNSCs after AHSCT is needed to improve the negative impact on outcomes.

Authors/Disclosures
Pierre Fayad, MD, FAHA, FAAN (University of Nebraska Medical Center) PRESENTER	Dr. Fayad has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Fayad has received personal compensation in the range of $0-$499 for serving as a Member Data Safety & Monitoring Committee with NINDS.
	No disclosure on file
Giancarlo Comi, MD (University Vita-Salute)	Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.
	No disclosure on file
	No disclosure on file
Vamshi Balasetti, MD (Washington University St Louis School of Medicine)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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