ABSTRACT
Hematopoietic cell transplantation (HCT) involves the intravenous infusion of hematopoietic
progenitor cells from the patient (autologous) or a human leukocyte antigen-matched
donor (allogeneic). Before transplantation, the recipient undergoes a conditioning
regimen with high-dose chemotherapy or radiotherapy (or both) to destroy a defective
bone marrow or residual cancer cells. After allogenic HCT chronic immunosuppression
is needed to prevent graft rejection and graft-versus-host disease. The frequency
and type of neurological complication depends on the type of HCT, the underlying disease,
and the case ascertainment. In this review the neurological complications are presented
according to the stage of HCT that they are most likely to occur: (1) conditioning:
drug-related encephalopathies and seizures or complications secondary to medical procedures;
(2) bone marrow depletion: metabolic and drug-related encephalopathies and seizures,
septic cerebral infarctions, and hemorrhages; (3) chronic immunosuppression: infections
by viruses and opportunistic organisms; and (4) late events: central nervous system
relapses of the original disease, neurological complications of graft versus host
disease, and second neoplasms.
KEYWORDS
Hematopoietic cell transplantation - immunosuppression - neurotoxicity - subdural
hematoma - septic infarction - encephalitis
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