Abstracts

Rationale: Hematopoietic stem cell transplantation (HSCT) has gained worldwide acceptance as a treatment for pediatric patients with leukemia and other hematologic disorders. Neurologic complications are commonly associated with transplantation. However, research on pediatric epilepsy patients who have undergone HSCT is very limited, and the mechanism is unknown. Methods: From January, 2004 to December 2010, 54 cases of stem cell transplantation in Department of Pediatrics, of Yeungnam University hospital were investigated. We report five children who were diagnosed with epilepsy after HSCT. In 7-year follow-ups after transplantation, we assessed their clinical characteristics and neurophysiological, electroencephalographic, and neuroimaging results. Results: Five patients were diagnosed with epilepsy after HSCT. Two were diagnosed with ALL, two were diagnosed with AML and the other was diagnosed with NHL. Antiepileptic prophylaxis with phenobarbital was given to all patients, and they were treated with Busulphan, cyclophosphamide, melphalan, cytarabine, and TBI as a conditioning regimen. Four patients had partial seizures, and three of them developed secondary generalization. The semiology of the seizures was classified in accordance with the ILAE classification. We checked encephalography (EEG) and brain magnetic resonance imaging (MRI). All patients started treatment with anticonvulsants, but only 2 patients became seizure free. The other three, despite polytherapy, still suffer seizures. Conclusions: Epilepsy is a severe complication in pediatric patients who have undergone HSCT, and is associated with high morbidity and poor outcome. Neurologic complications in HSCT patients have been documented, but further study of epilepsy after transplantation is required. Funding: Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2014R1A1A2060062)