Objective: To investigate the risk factors for, and the incidence of, structural abnormalities on brain imaging in allogeneic
haematopoietic stem cell transplant (HSCT) patients, and correlate these findings with survival.
Methods: We retrospectively reviewed all brain computed tomography (CT) and/or magnetic resonance imaging (MRI) studies
obtained during the first post-HSCT year from 2004 thru 2007 in allogeneic HSCT recipients.
Results: A total of 128 patients had brain imaging in the first post-HSCT year. Forty one of these 128 patients (32 %) had structural
abnormalities on brain imaging: cerebrovascular complications (n = 10), central nervous system (CNS) infection (n = 9), subdural
fluid collection (n = 6), CNS recurrence of haematological malignancy (n = 11), and drug toxicity abnormalities (n = 5). The only
significant risk factor for structural imaging abnormality was younger patient age (P = 0.01). MRI was significantly more likely
than CT to provide specific imaging diagnosis of cerebral lesions (P = 0.001). HSCT patients with cerebrovascular complications
have poor survival (P < 0.05). However, overall survival was not significantly worse for the 41 patients with the structural imaging
abnormalities as compared to the 87 patients who had brain imaging but no structural abnormalities.
Conclusions: There was no survival difference in patients whose brain imaging was normal or abnormal. However, there was
poor outcome in patients with cerebrovascular complications after HSCT.
Key Points: ? Brain imaging frequently demonstrates neurological complications following haematopoietic stem cell
transplantation. ? Younger HSCT patients are more likely to exhibit abnormal brain imaging findings. ? HSCT recipients with
cerebrovascular complications have the worst survival. ? However brain imaging results are weak indicators of overall survival
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