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Sixty-four patients(56%)had neurologic complications.Sixteen developed more than one complication.Twenty-seven patients(25%)had major neurologic complications:metabolic encephalopathy(8),seizures(8),psychiatric symptoms (3),cerebral hemorrhage(1),cerebral abscess(1),leukemic meningitis(1), peripheral neuropathies(1)and myopathies(2).Forty patients(35%)had minor complications including headache(16)and tremor(31).Major neurologic complications occurred after engraftment in most patients.Metabolic encephalopathy correlated with graft vs host disease(GvHD).Seven percent of patients had generalized seizures that occurred without signs of structural cerebral lesions.Probability of survival at day 90 was lower in patients with than in those without any major central nervous system complications.Neurologic complications are frequent during the first three months following BMT and affect patient survival.Drug neurotoxicity and acute GvHD are the main factors influencing their occurrence. |
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