Rosenfeld Myrna R, Pruitt Amy
Department of Neurology, University of Pennsylvania, Philadelphia, 19104, USA.
Semin Oncol. 2006 Jun;33(3):352-61. doi: 10.1053/j.seminoncol.2006.03.003.
Bone marrow and peripheral blood stem cell transplantation are part of the standard of care for a variety of oncologic and non-oncologic disorders and are associated with a large spectrum of neurologic complications. These complications may arise at any time during and after the transplantation process, especially in subjects requiring chronic immunosuppression, and are most frequently related to infections, cerebrovascular or metabolic events, and toxicity from radiation or chemotherapy. Due to the unique circumstances and treatments surrounding each step in the transplantation process, there is a higher incidence of some neurologic complications during discrete time periods. Being aware of the temporal relationship of the neurologic disorder within the transplantation process can therefore facilitate diagnosis and institution of appropriate therapy. Neurologic complications after solid organ transplantation are often due to similar mechanisms as in patients after bone marrow and stem cell transplantation although there are several complications unique to these patients such as transmission of infectious agents by the donated organ. For these patients, the clinician needs to have a high index of suspicion that the neurologic problem is related to the transplant.
骨髓和外周血干细胞移植是多种肿瘤和非肿瘤疾病标准治疗的一部分，且与一系列神经系统并发症相关。这些并发症可能在移植过程中和移植后任何时间出现，尤其是在需要长期免疫抑制的患者中，并且最常与感染、脑血管或代谢事件以及放疗或化疗的毒性有关。由于移植过程中每个步骤的独特情况和治疗方法，在特定时间段内某些神经系统并发症的发生率较高。因此，了解移植过程中神经系统疾病的时间关系有助于诊断并采取适当的治疗措施。实体器官移植后的神经系统并发症通常与骨髓和干细胞移植患者的机制相似，尽管这些患者有一些独特的并发症，如捐赠器官传播感染因子。对于这些患者，临床医生需要高度怀疑神经系统问题与移植有关。
