Bartynski Walter S, Zeigler Zella R, Shadduck Richard K, Lister John
Department of Radiology, The Western Pennsylvania Hospital, Pittsburgh, PA 15213, USA.
Neurocrit Care. 2005;3(1):33-45. doi: 10.1385/NCC:3:1:033.
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).
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.
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%).
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.
本研究旨在探讨接受治疗的恶性疾病是否会影响清髓性预处理及异基因骨髓移植（allo-BMT）后环孢素或FK-506神经毒性的发生率。
回顾290例在allo-BMT及使用环孢素/FK-506之前接受清髓性预处理的患者，其中21例（7.2%）经计算机断层扫描或磁共振成像确诊为神经毒性。需要进行allo-BMT的潜在恶性疾病包括白血病（67%）、淋巴瘤（10%）、骨髓增生异常综合征（10%）和多发性骨髓瘤（MM）。比较了不同疾病的神经毒性发生率。
神经毒性发生率最高的是MM（25%），而最低的是淋巴瘤（2.7%）。其他疾病的发生率处于中间水平，包括急性白血病（10%）、骨髓增生异常综合征（6.4%）和慢性粒细胞白血病（4.9%）。
环孢素/FK-506神经毒性因潜在恶性疾病而异。该人群对神经毒性发生的易感性差异可能取决于宿主血管系统与疾病特异性因素的相互作用。了解神经毒性的原因有助于提高allo-BMT后的生存率。
