Observational Study of Tacrolimus-Induced Posterior Reversible Encephalopathy Syndrome in Allogeneic Stem Cell Transplantation

Abstract Posterior reversible encephalopathy syndrome (PRES) is one of the most serious complication after allogeneic stem cell transplantation in paediatric setting. It is most commonly reported as adverse event of immunosuppressive strategies during transplantation. We present a case of a 7 years old girl with myelodysplastic syndrome (MDS) treated with allogeneic stem cell transplantation (ASCT) at our department. Diagnosis of PRES was confirmed by imaging techniques during the first month after transplant and it was very likely connected with cyclosporine neurotoxicity. The aim of this article is to present our first experience in diagnosing and treating PRES in paediatric stem cell transplantation. Our experience showed that PRES is one of the reasons for higher transplant related mortality in children. Early prediction of factors contributing to PRES and closely monitoring of patient’s vital signs, especially blood pressure, neurological status and vision are the main contributors for challenging the patient with another immunosuppressive agent that has less neurological toxicity. Still studies have to be initiated to confirm the influence of PRES on transplant outcome.

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Cyclosporine-related posterior reversible encephalopathy syndrome after cord blood stem cell transplantation

Hematology/Oncology and Stem Cell Therapy ◽

10.1016/j.hemonc.2013.05.002 ◽

2013 ◽

Vol 6 (2) ◽

pp. 71 ◽

Cited By ~ 4

Author(s):

Selim Jennane ◽

El Mehdi Mahtat ◽

Johanna Konopacki ◽

Jean Valère Malfuson ◽

Kamal Doghmi ◽

...

Keyword(s):

Stem Cell ◽

Stem Cell Transplantation ◽

Cord Blood ◽

Cell Transplantation ◽

Posterior Reversible Encephalopathy Syndrome ◽

Blood Stem Cell ◽

Posterior Reversible Encephalopathy ◽

Cord Blood Stem Cell ◽

Reversible Encephalopathy ◽

Blood Stem Cell Transplantation

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Neuroimaging Findings of Posterior Reversible Encephalopathy Syndrome (PRES) Following Hematopoietic Stem Cell Transplantation in Pediatric Recipients

10.21203/rs.3.rs-593910/v1 ◽

2021 ◽

Author(s):

Ali Onder Atca ◽

Berrin Erok ◽

Selime Aydogdu

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Posterior Reversible Encephalopathy Syndrome ◽

Hematopoietic Stem ◽

Posterior Reversible Encephalopathy ◽

Reversible Encephalopathy

Abstract Background: Hematopoietic stem cell transplantation (HSCT) is the intravenous infusion of hematopoietic progenitor cells derived from bone marrow, umblical cord blood or peripheral blood to restore hematologic and immunologic functions of bone marrow. HSCT is the only curative treatment in many childhood disorders and is used worldwide. However, serious complications are still an important concern of management. Central nervous system (CNS) complications in pediatric HSCT recipients can be associated with high morbidity and mortality. Posterior reversible encephalopathy syndrome (PRES) is the most common of these neuroimaging abnormalities in patients having neurological symptoms following HSCT. The most common presentation is posterior encephalopathy in which the lesions are located at the posterior parts of cerebral hemispheres, namely parietooccipital lobes. However, it can also be found in non-posterior distribution and can be accompanied by various atypical imaging manifestattions like restricted diffusion. Methods: In this study, we aimed to describe the typical and also uncommon neuroimaging manifestations of PRES following HSCT in our pediatric patients.We evaluated the medical records of 300 pediatric HSCT recipients.Results: We detected 14 cases of PRES, of which there were 3 cases of atypical neuroimaging manifestations, regarding both the sites of involvement and also the magnetic resonance imaging (MRI) manifestations. Conclusion: Such different presentations should not dissuade the diagnosis of PRES in the appropriate clinical settings in order to manage these patients timely and accurately.

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