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RISS 인기검색어
- 검색키워드
- 저자 : 양동원(Dong Weon Yang) (검색결과 2 건)
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양동원(Dong Weon Yang),김범생(Beum Saeng Kim),박종원(Chong Won Park),김춘추(Choon Choo Kim),김동집(Dong Jip Kim) 대한내과학회 1995 대한내과학회지 Vol.49 No.3
N/A Objectives: Bone marrow transplantation(BMT) is the treatment of choice for hematologic malignancies, certain inborn error of metabolism, lympho-reticular and some solid malignacies. BMT receipients are Ex- posed to several potential sources of neurologic damage, including the original disease and its treatment such as radiation, therapy chemotherapy and immunosuppressant. In this report we retrospectively studied the clinical aspets of neurologic complications in 206 patients who had underwent bone marrow transplantation. Methoda We retrospectively analyzed neurologic complications in 206 BMT recipients (leukemia 126, severe aplastic anemia 62, solid tumors 6, non Hodg-kins lymphoma 4, multiple myeloma 3, myelody-spoietic syndrome 5) during the last 11 years (1983. 3.1-1994. 3.1). Neuroloic complications were classified as cerebrovascular disease, herpes zoster infection, central nervous system infection, seizure and facial palsy. The frequency of nervous system infection between BMT recipients with and without graft versus host-disease(GVHD) were statiscally analysed with chisquare statistic (p=0.05). Results: Neurologic complications were present in 28 patients(14%) and three of them had more than one complication, so total cases of neurologic complications were 34. The most common neurologic complication was herpes-zoster infection(12 cases, 35 % ). The lesion involved frequently in the thoracic dermatome with a more disseminated nature. Seizure was observed in 9 cases(27% ). The six of them were fatal and associated with severe systemic complications or CNS infections. Central nervous system infections occured in 6 cases(18%). The mast common organism was Streptococcus pneumoniae(50%). Cerebrovascular diseases were encountered in 5 cases(14%, 3 infractions, 2 hemorrhages). Among them, 3cases(50%) were associated with CNS infection, so it is an important cause of cerebrovascular disease, which probably associated with cerebral vasculitis. Peripheral type facial palsy was developed in 2 cases(6%) with good prognosis. Neurologic complications occured only in allogenic transplants and nervous system infection(hepes zoster and CNS infection) occurred about two times more frequently in BMT patients with GVHD. But the presence of GVHD implied no statitic significance in the development of nervous system infection (p<0.05). Conclusion: The most common neurologic complication of BMT was herpes zoster infection. Among neurologic complications seizure, CNS infection and cerebrovascular diseases had high mortality to need urgent and intensive care. The causes of neurologic complications of BMT had not been accurately understood but immunosuppression due to chemotherapy, radiation and immunosspressants such as cyclosporine A, Methotrexate or corticosteroid is well known important factor. Safe and effective immunosuppression level must be controlled to prevent GVHD and neurologic complications simultaneously.
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