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Association of graft-versus-host-disease with neurologic complications: clinical paradigm and future directions

Bone Marrow Transplantation volume 56, pages 1471–1473 (2021)Cite this article

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Graft-versus-host disease (GVHD) is a well-known complication of hematopoietic cell transplantation (HCT) [1, 2]. GVHD can be classified into acute GVHD (aGVHD) and chronic GVHD (cGVHD), initially based at the day +100 mark, but corroborated more recently based on clinical features [1, 3], with varying incidences and disease patterns. Additionally, HCT also increases the risk of developing certain neurological complications (NCs). Each NC possesses unique risk factors which can indicate a higher likelihood that such will develop. However, while both GVHD and NCs are common complications of HCT and have been well studied, the association of GVHD with post-HCT NCs remains to be elucidated.

Herein, we conducted a systematic electronic search regarding the occurrence of noninfectious NCs and GVHD in HCT recipients, gauging the concurrence of GVHD with each complication to establish a possible association. The study was conducted as per the PICO criteria [4]. Studies meeting the inclusion criteria consisted of case reports, case series, clinical trials, and retrospective studies; those excluded were systematic reviews, meta-analyses, review articles, and preclinical studies. The NCs that were included in the systematic review were comprised of the following:

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Authors and Affiliations

  1. Allama Iqbal Medical College/Jinnah Hospital, Lahore, Pakistan

    Mohammad Abdurrehman Sheikh

  2. Division of Hematology–Oncology, Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Annie Im

  3. Division of Hematology and Oncology, University of Virginia Health System, Charlottesville, VA, USA

    Karen Ballen

  4. Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Shahrukh K. Hashmi

Authors
  1. Mohammad Abdurrehman Sheikh
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  2. Annie Im
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Contributions

MAS and SKH wrote the first draft. All authors contributed substantially to the conception, acquisition, analysis, and interpretation of the data for the work and approved the final approval of the version to be published.

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Correspondence to Shahrukh K. Hashmi.

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Conflict of interest

None of the authors declare any relevant conflicts of interest. SKH has received honoraria from Janssen, Mallinckrodt, Novartis, and Pfizer. SKH has received travel grants from Sanofi, Gilead, and Merck.

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Sheikh, M.A., Im, A., Ballen, K. et al. Association of graft-versus-host-disease with neurologic complications: clinical paradigm and future directions. Bone Marrow Transplant 56, 1471–1473 (2021). https://doi.org/10.1038/s41409-021-01216-x

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