Central Nervous System Complications after Allogeneic Hematopoietic Stem Cell Transplantation: Incidence, Manifestations, and Clinical Significance
Bibliographic record
Abstract
The incidence of central nervous system (CNS) complications, their risk factors, and impact on outcome are not well defined in recipients of allogeneic hematopoietic stem cell transplant (aHSCT). We reviewed the medical records of 302 consecutive patients who underwent aHSCT for malignant and nonmalignant hematologic diseases at Princess Margaret Hospital between 2002 and 2005. The cumulative incidences of all CNS complications and posterior reversible encephalopathy syndrome (PRES) at days 100 and 365 were 18% (95% confidence interval [CI]: 14-22) and 23% (95% CI: 19-29), and 6% (95% CI: 4-9) and 7% (95% CI: 5-11), respectively. Seizures occurred in 37% of all CNS events in the first 100 days and 73% of PRES episodes. Female gender and high-dose total-body irridiation (TBI) were identified as independent risk factors for CNS complications in the first 100 days posttransplant. Survival at 1-year was significantly inferior in patients who developed CNS complications within 100 days of transplant (28% [95% CI: 17-41] versus 72% [95% CI: 66-77]) and PRES (27% [95% CI: 10-47] versus 67% [95% CI: 62-73]) compared to those who did not (P < .0001). Death from graft-versus-host disease (GVHD) was more common in patients with CNS complications in the first 100 days (P = .006) and PRES (P = .01) compared to patients without complications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".