PMID- 8832009
OWN - NLM
STAT- MEDLINE
DCOM- 19970227
LR  - 20131121
IS  - 0268-3369 (Print)
IS  - 0268-3369 (Linking)
VI  - 18
IP  - 1
DP  - 1996 Jul
TI  - CsA-associated neurotoxicity and ineffective prophylaxis with clonazepam in 
      patients transplanted for thalassemia major: analysis of risk factors.
PG  - 157-62
AB  - Cyclosporin A (CsA) has been shown to be useful in the prophylaxis of acute 
      graft-versus-host-disease (GVHD). However, this immunosuppressive agent produces 
      multiple side-effects including nephrotoxicity, hypertension, hypertricosis, gum 
      hyperplasia, infections, and neurotoxicity. We report a retrospective analysis of 
      neurotoxicity in 625 recipients transplanted for thalassemia and given CsA as 
      part of GVHD prophylaxis. Neurotoxicity consisted in mental status changes, 
      tremor, headache (grade 1), visual disturbance and cortical blindness (grade 2) 
      and seizures and coma (grade 3). The overall toxicity was 28.8% and the incidence 
      of convulsions was 10.1%. Neurological findings were reversible after temporary 
      reduction or discontinuation of CsA. Class 3 patients, when prepared with 
      protocol 6 (Bu 14 + Cy 200 and CsA for GVHD) or when they developed acute GVHD, 
      had the highest risk of convulsions. Age, sex, different conditioning regimens, 
      different anticonvulsive prophylaxis, liver damage due to iron-overload and/or to 
      chronic inflammation did not influence the occurrence of CsA-related CNS 
      toxicity. The occurrence of acute GVHD with concomitant use of high-dose 
      corticosteroids is the single significant predisposing factor in the occurrence 
      of convulsions. Grades 1 and 2 of neurotoxicity occurred earlier and were not 
      influenced even by acute GVHD.
FAU - Erer, B
AU  - Erer B
AD  - Divisione di Ematologica, Azienda Ospedaliera Di Pasaro, Italy.
FAU - Polchi, P
AU  - Polchi P
FAU - Lucarelli, G
AU  - Lucarelli G
FAU - Angelucci, E
AU  - Angelucci E
FAU - Baronciani, D
AU  - Baronciani D
FAU - Galimberti, M
AU  - Galimberti M
FAU - Giardini, C
AU  - Giardini C
FAU - Gaziev, D
AU  - Gaziev D
FAU - Maiello, A
AU  - Maiello A
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Marrow Transplant
JT  - Bone marrow transplantation
JID - 8702459
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anticonvulsants)
RN  - 0 (Immunosuppressive Agents)
RN  - 5PE9FDE8GB (Clonazepam)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - G1LN9045DK (Busulfan)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adrenal Cortex Hormones/adverse effects
MH  - Adult
MH  - Anticonvulsants/*therapeutic use
MH  - Blood Transfusion
MH  - *Bone Marrow Transplantation
MH  - Busulfan/adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Clonazepam/*therapeutic use
MH  - Coma/chemically induced/epidemiology
MH  - Combined Modality Therapy
MH  - Comorbidity
MH  - Cyclophosphamide/adverse effects
MH  - Cyclosporine/*adverse effects/therapeutic use
MH  - Female
MH  - Graft vs Host Disease/prevention & control
MH  - Hemosiderosis/complications
MH  - Humans
MH  - Hypertension/epidemiology
MH  - Immunosuppressive Agents/*adverse effects/therapeutic use
MH  - Incidence
MH  - Infant
MH  - Liver Diseases/epidemiology
MH  - Magnesium Deficiency/complications
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Nervous System Diseases/*chemically induced/diagnosis/epidemiology/prevention & 
      control
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Seizures/chemically induced/epidemiology/prevention & control
MH  - Tomography, X-Ray Computed
MH  - Transplantation Conditioning/adverse effects
MH  - Treatment Failure
MH  - Vision Disorders/chemically induced/epidemiology
MH  - beta-Thalassemia/immunology/*therapy
EDAT- 1996/07/01 00:00
MHDA- 1996/07/01 00:01
CRDT- 1996/07/01 00:00
PHST- 1996/07/01 00:00 [pubmed]
PHST- 1996/07/01 00:01 [medline]
PHST- 1996/07/01 00:00 [entrez]
PST - ppublish
SO  - Bone Marrow Transplant. 1996 Jul;18(1):157-62.