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PRES in Pediatric HSCT: A Single-Center Experience
Rajan Kapoor1, Ashish Simalti2, Rajiv Kumar1
1Departments of Medicine and Clinical Hematology.
Journal of Pediatric Hematology/Oncology
|April 27, 2018
Summary
Posterior reversible encephalopathy syndrome (PRES) after hematopoietic stem cell transplant (HSCT) is linked to serious complications. Early identification and management are crucial for improving HSCT outcomes.
Area of Science:
- Neurology
- Hematology
- Transplantation Medicine
Background:
- Posterior reversible encephalopathy syndrome (PRES) is a neurological condition with varied causes.
- PRES is increasingly recognized as a complication following hematopoietic stem cell transplant (HSCT).
- Understanding the specific risks and outcomes of PRES in the HSCT population is critical.
Observation:
- This retrospective study analyzed 35 pediatric HSCT recipients over two years.
- 17% of patients developed PRES, with headache and seizures as primary symptoms.
- Calcineurin inhibitors were administered to all patients at PRES onset, occurring a median of 21 days post-HSCT.
Findings:
- PRES in HSCT recipients is associated with significant adverse events.
- 34% of patients experienced residual neurological deficits.
- Graft rejection occurred in 50% of patients, necessitating a return to transfusion dependence.
Implications:
- PRES occurrence significantly impacts HSCT success rates.
- Graft rejection and graft-versus-host disease are serious concerns post-PRES.
- Development of improved immunosuppression transition protocols is essential to mitigate PRES-related risks in HSCT.
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