Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Complications

Intracranial hemorrhage following bone marrow transplantation: an autopsy study of 58 patients

Bone Marrow Transplantation volume 29, pages 29–32 (2002)Cite this article

Abstract

Autopsy files of 180 patients were reviewed, who died after BMT between July 1987 and June 1998 and 58 (32.2%) cases, who had experienced intracranial hemorrhage (ICH) were selected. Age, sex, underlying disease, preparatory regimens, immunoprophylaxis, chronic and acute GVHD, survival of the patients and localization and size of hemorrhages were evaluated. There were 33 males and 25 females, with a mean age of 23.4 years. The main underlying disorders for which BMT was performed included SAA (n = 21), CML (n = 13) and AML (n = 10). Forty patients were found to have intraparenchymal hemorrhage, 35 had subarachnoid hemorrhage and eight patients had subdural hemorrhage. In 16 cases the CNS hemorrhage was so extensive that it was considered to be the main cause of death. There was no significant statistical difference concerning sex (P = 0.217), age (P = 0.296), underlying disease (P = 0.352), preparatory regimens (P = 0.07), immunoprophylaxis (P = 0.914), chronic and acute graft-versus-host disease (P = 0.107 and P = 0.631, respectively) and survival (P = 0.701) when comparing patients with or without ICH. However, the number of cases in which the CNS was defined as the main cause of death was higher among patients with ICH than in patients without ICH (n = 16 vs 15) (P = 0.011). We conclude that ICH is common and has a significant mortality rate following BMT.

Bone Marrow Transplantation (2002) 29, 29–32. doi:10.1038/sj.bmt.1703315

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Armitage JO . Bone marrow transplantation New Engl J Med 1994 330: 827 838

    Article  CAS  PubMed  Google Scholar 

  2. de Medeiros BC, de Medeiros CR, Werner B et al. Central nervous system infections following bone marrow transplantation: an autopsy report of 27 cases J Hematother Stem Cell Res 2000 9: 535 540

    Article  CAS  PubMed  Google Scholar 

  3. Graus F, Saiz A, Sierra J et al. Neurologic complications of autologous and allogeneic bone marrow transplantation in patients with leukemia: a comparative study Neurology 1996 46: 1004 1009

    Article  CAS  PubMed  Google Scholar 

  4. Mohrmann RL, Mah V, Vinters HV . Neuropathologic findings after bone marrow transplantation: an autopsy study Hum Pathol 1990 21: 630 639

    Article  CAS  PubMed  Google Scholar 

  5. Patchell RA, White CL III, Clark AW et al. Neurologic complications of bone marrow transplantation Neurology 1985 35: 300 306

    Article  CAS  PubMed  Google Scholar 

  6. Bleggi-Torres LF, Medeiros BC, Werner B et al. Neuropathologic findings after bone marrow transplantation: an autopsy study of 180 cases Bone Marrow Transplant 2000 25: 301 307

    Article  CAS  PubMed  Google Scholar 

  7. Bleggi-Torres LF, de Medeiros BC, Neto JZ et al. Disseminated Fusarium sp. infection affecting the brain of a child after bone marrow transplantation Bone Marrow Transplant 1996 18: 1013 1015

    CAS  PubMed  Google Scholar 

  8. McFarlane ML . Absence of demographic bias in selecion for necropsy Arch Pathol Lab Med 1987 111: 67 70

    CAS  PubMed  Google Scholar 

  9. McFarlane MJ, Feinstein AR, Wells CK et al. The ‘epidemiologic necropsy’. Unexpected detections, demographic selections, and charging rates of lung cancer JAMA 1987 258: 331 338

    Article  CAS  PubMed  Google Scholar 

  10. Nevo S, Swan V, Enger C et al. Acute bleeding after bone marrow transplantation (BMT) – incidence and effect on survival. A quantitative analysis in 1402 patients Blood 1998 91: 1469 1477

    CAS  PubMed  Google Scholar 

  11. Antonini G, Ceschin V, Morino S et al. Early neurologic complications following allogeneic bone marrow transplant for leukemia. A prospective study Neurology 1998 50: 1441 1445

    Article  CAS  PubMed  Google Scholar 

  12. Pomeranz S, Naparstek E, Ashkenazi E et al. Intracranial haematomas following bone marrow transplantation J Neurol 1994 241: 252 256

    Article  CAS  PubMed  Google Scholar 

  13. Mehta J, Powles R, Singhal S et al. Early identification of patients at risk of death due to infections, hemorrhage, or graft failure after allogeneic bone marrow transplantation on the basis of the leukocyte counts Bone Marrow Transplant 1997 19: 349 355

    Article  CAS  PubMed  Google Scholar 

  14. Oppenheim-Eden A, Glantz L, Eidelman LA, Sprung CL . Spontaneous intracerebral hemorrhage in critically ill patients: incidence over six years and associated factors Intensive Care Med 1999 25: 63 67

    Article  CAS  PubMed  Google Scholar 

  15. Pasquini R, Medeiros CR, Faoro LN et al. Fanconi anemia and the prevalence of central nervous system hemorrhage post bone marrow transplant Blood 2000 96: 333b (Abstr. 187)

    Google Scholar 

  16. Tornebohm E, Lockner D, Paul C . A retrospective analysis of bleeding complications in 438 patients with acute leukemia during the years 1972–1991 Eur J Haematol 1993 50: 160 167

    Article  CAS  PubMed  Google Scholar 

  17. Bleggi-Torres LF, Medeiros BC, Ogasawara VSA et al. Iatrogenic Wernicke's encephalopathy in allogeneic bone marrow transplantation: a study of eight cases Bone Marrow Transplant 1997 20: 391 395

    Article  CAS  PubMed  Google Scholar 

  18. Colosimo M, McCarthy N, Jayasinghe R et al. Diagnosis and management of subdural haematoma complicating bone marrow transplantation Bone Marrow Transplant 2000 25: 549 552

    Article  CAS  PubMed  Google Scholar 

  19. Bleggi-Torres LF, de Medeiros BC, Werner B et al. Unusual presentation of cerebral toxoplasmosis after BMT Bone Marrow Transplant 1999 23: 855 856

    Article  CAS  PubMed  Google Scholar 

  20. Zanis-Neto J, Ribeiro RC, Medeiros CR . Bone marrow transplantation for patients with Fanconi anemia: a study of 24 cases from a single institution Bone Marrow Transplant 1995 15: 293 298

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Hospital de Clinicas, University of Parana, Curitiba, Brazil

    LF Bleggi-Torres, B Werner & EL Gasparetto

  2. Bone Marrow Transplantation Unit, Hospital de Clinicas, University of Parana, Curitiba, Brazil

    BC de Medeiros, R Pasquini & CR de Medeiros

Authors
  1. LF Bleggi-Torres
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B Werner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. EL Gasparetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. BC de Medeiros
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R Pasquini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. CR de Medeiros
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bleggi-Torres, L., Werner, B., Gasparetto, E. et al. Intracranial hemorrhage following bone marrow transplantation: an autopsy study of 58 patients. Bone Marrow Transplant 29, 29–32 (2002). https://doi.org/10.1038/sj.bmt.1703315

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703315

Keywords

This article is cited by

Search

Advanced search

Quick links