Variable incidence of cyclosporine and FK-506 neurotoxicity in hematopoeitic malignancies and marrow conditions after allogeneic bone marrow transplantation.
BACKGROUND
This study examines whether malignant disease under treatment influences the incidence of cyclosporine or FK-506 neurotoxicity after myeloablative conditioning and allogeneic bone marrow transplantation (allo-BMT).


METHODS
Review of 290 patients who received myeloablative conditioning prior to allo-BMT and cyclosporine/FK-506 identified 21 (7.2%) patients with neurotoxicity confirmed by computed tomography or magnetic resonance. Underlying malignancy necessitating allo-BMT included leukemias (67%), lymphoma (10%), myelodysplastic syndrome (10%), and multiple myeloma (MM). Frequency of neurotoxicity by disease was compared.


RESULTS
The highest incidence of neurotoxicity was present with MM (25%), whereas the lowest incidence was present with lymphoma (2.7%). Other diseases demonstrated intermediate incidence, including acute leukemias (10%), myelodysplastic syndrome (6.4%), and chronic myelogenous leukemia (4.9%).


CONCLUSIONS
Cyclosporine/FK-506 neurotoxicity varied according to the underlying malignancy. The variable susceptibility to the development of neurotoxicity in this population may depend on the interaction of host vasculature with disease specific factors. Understanding the cause of neurotoxicity could improve survival after allo-BMT.
Bartynski
Walter S
WS
Department of Radiology, The Western Pennsylvania Hospital, Pittsburgh, PA 15213, USA. bartynskiws@upmc.edu
Zeigler
Zella R
ZR
Shadduck
Richard K
RK
Lister
John
J
D016026:Bone Marrow Transplantation / Q000473:pathology*; D003520:Cyclophosphamide / Q000009:adverse effects*; D016572:Cyclosporine / Q000009:adverse effects*; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000145:classification / Q000601:surgery*; D006801:Humans; D019194:Ischemic Preconditioning; D008279:Magnetic Resonance Imaging; D020258:Neurotoxicity Syndromes / Q000453:epidemiology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous / Q000276:immunology*
D016572:Cyclosporine; D003520:Cyclophosphamide