Table 3.
Characteristics and treatment of CSA related neurotoxicity
| Patient number | #1 | #2 | #3 | #4 | #5 | #6 |
|---|---|---|---|---|---|---|
| Day of onset post HSCT | 1 | 5 | 40 | 20 | 7 | 15 |
| CSA levels (ng/ml) | 69 | 250 | 194 | 179 | 177 | 150 |
| Mg levels (mEq/l) | 0.88 | 0.86 | 0.95 | 0.72 | 0.85 | 1.03 |
| Cholesterol and tryglicerides levels (mg/dl) |
123/82 | 152/64 | 125/137 | 195/139 | 136/162 | 177/79 |
| Prodromes | headache & vomiting | headache & HTN | HTN | HTN | HTN | HTN & blurred vision |
| Neurological signs | gen seiz | confusion | gen seiz | gen seiz | gen seiz | blurred vision |
| Acute treatment | LOR P PB |
mannitol* | LOR P |
LOR P |
LOR P |
mannitol* |
| Chronic treatment | P PB |
none | P | P | P | P CLO |
| Outcome (day last follow-up | Alive & well (+1065) |
Alive & well (+1059) |
Alive & well (+1005) |
Alive & well (+760) |
Died, grade IV GVHD (+60) | Alive & well (+320) |
Mg = magnesium
HTN = arterial hypertension
gen seiz = generalized seizures
LOR = lorazepam 0.05 mg/kg/dose iv
P = phenitoyn 15 mg/kg/dose iv for acute treatment
phenitoyn 7 mg/kg/day iv for maintenance treatment
PB = Phenobarbital 7 mg/kg/day iv
* 0.5 g/kg/dose iv
CLO = oral clonazepam 0.05 mg/kg/day