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Long-term outcomes of allogeneic stem cell transplant recipients after calcineurin inhibitor-induced neurotoxicity
Journal article   Peer reviewed

Long-term outcomes of allogeneic stem cell transplant recipients after calcineurin inhibitor-induced neurotoxicity

Rizwana CHOHAN, Ravi VIJ, Hanna KHOURY, Douglas ADKINS, William BLUM, Randy BROWN, Michael TOMASSON, Steven DEVINE, Timothy GRAUBERT, Lawrence T GOODNOUGH, …
British journal of haematology, Vol.123(1), pp.110-113
2003
DOI: 10.1046/j.1365-2141.2003.04550.x
PMID: 14510951

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Abstract

Calcineurin inhibitor-induced central nervous system toxicities are uncommon and often resolve after discontinuation of the offending drug. The long-term outcome of these patients is, however, unknown. Resolution of symptoms occurred in 70% of 30 allografted recipients who developed calcineurin inhibitor-induced neurotoxicity. When patients were rechallenged with the same or a different calcineurin inhibitor, symptoms recurred in 41%, leading to permanent discontinuation of the drug. De novo or progressive acute graft-versus-host disease (GVHD) was observed in 54% of patients at a median of 7 d (range 1-70 d) after initial onset of neurotoxicity. The prognosis was grim, with 24 (80%) of these patients dying a median 33 d after the onset of neurotoxicity (range 2-594 d). GVHD and/or infection occurred in 54% and were the most common primary causes of death. We conclude that calcineurin inhibitor-induced neurotoxicity is frequently reversible but associated with a poor prognosis.
Biological and medical sciences Toxicity: nervous system and muscle Medical sciences Drug toxicity and drugs side effects treatment Pharmacology. Drug treatments

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