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Departments of Neurology (Drs. Patchell and Clark) and Pathology (Drs. White, Clark, and Beschorner) and The Bone Marrow Transplant Unit (Dr. Santos). Johns Hopkins Hospital, Baltimore, MD.
Among 78 patients who died after bone marrow transplantation, neurologic complications were present in 55 (70%) and were the cause of death in 5 (6%). Metabolic encephalopathy occurred in 29 patients (37%). CNS infections included aspergillosis (3), herpes simplex encephalitis (2), and Listeria monocytogenes meningitis (1). Six additional patients had neuropathologic changes possibly due to cytomegalovirus infection. Cerebrovascular complications occurred in five patients (two hemorrhages and three infarcts). All infarcts were associated with endocarditis. The rate of nonbacterial thrombotic endocarditis was significantly higher (p < 0.001) than in the general autopsy population. CNS leukemia and therapy-induced injury were rare. There was no evidence of graft-versus-host disease involving the CNS.
Address correspondence and reprint requests to Dr. Patchell, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York. NY 10021.
Supported in part by PHS grant CA-15396, awarded by the National Cancer Institute DHHS.
Accepted for publication June 14, 1984.
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