Cyclosporin A-associated status epilepticus related to hematopoietic stem cell transplantation for thalassemia.
Cyclosporin A is an essential drug for graft versus host disease (GvHD) prophylaxis in allogeneic hematopoietic stem cell transplantation. Cyclosporin A-associated neurotoxicity is common but poorly understood. The authors herein report on 3 patients receiving transplants for thalassemia. GvHD prophylaxis included cyclosporin A, prednisolone, and methotrexate. All patients developed a status epilepticus with cortical signal alterations located mainly in occipital regions on T2-weighted magnetic resonance imaging. Complete disappearance of the neurologic symptoms and radiographic findings was observed without discontinuing cyclosporin A therapy. Especially, pediatric thalassemics receiving busulfan/cyclophosphamide as preparative regimen seem to be significantly prone to cyclosporin A-associated seizures.
Zakrzewski
Johannes L
JL
Bone Marrow Transplantation Center Idar-Oberstein, Idar-Oberstein, Germany. johannes.zakrzewski@uni-essen.de
D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use; D002066:Busulfan / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000009:adverse effects; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D004198:Disease Susceptibility; D004829:Epilepsy, Generalized / Q000139:chemically induced; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D011292:Premedication; D013226:Status Epilepticus / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D013789:Thalassemia / Q000150:complications / Q000628:therapy*; D019172:Transplantation Conditioning / Q000009:adverse effects
D000927:Anticonvulsants; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003520:Cyclophosphamide; D002066:Busulfan