Viral encephalitis after haplo-identical hematopoietic stem cell transplantation: Causative viral spectrum, characteristics, and risk factors.

Abstract:

OBJECTIVE:To retrospectively identify characteristics and risk factors of viral encephalitis (VE) in patients who underwent a haplo-identical hematopoietic stem cell transplant (HSCT). METHODS:A nested case-control study was designed. Cases with VE and controls were identified from a cohort composed of 1274 patients who underwent a haplo-identical HSCT from 2012 to 2015. RESULTS:VE was identified in 30 patients (2.4%). The median time from HSCT to diagnosis was 144.5 days. The viruses detected included RSV-B (43.3%), BKV (23.3%), more than one virus (10%), cytomegalovirus (CMV) (6.7%), RSV-A (6.7%), HSV (3.3%), HHV-6 (3.3%), and CVB3 (3.3%). Alterations of consciousness and seizures were the most frequently presented symptoms. Neuroimaging detected abnormalities in 19 (76%) patients. The cerebral spinal fluid cell count, protein, and glucose concentration were elevated in eight (26.7%), 18(60%), and nine (30%) patients, respectively. The treatment efficacy and prognoses varied considerably based on the different causative viruses. Multivariate analyses revealed that acute graft-versus-host disease (grade III-IV), CMV viremia, and engraftment syndrome were significantly and independently associated with VE. The cumulative mortality rate was significantly higher in patients suffering from VE than in the controls. CONCLUSION:Characteristics, such as onset time, response to treatment, and outcome, varied based on the different causative viruses.

journal_name

Eur J Haematol

authors

Zhang XH,Zhang JM,Han W,Chen H,Chen YH,Wang FR,Wang JZ,Zhang YY,Mo XD,Chen Y,Wang Y,Chang YJ,Xu LP,Liu KY,Huang XJ

doi

10.1111/ejh.12855

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

450-458

issue

5

eissn

0902-4441

issn

1600-0609

journal_volume

98

pub_type

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