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Komplikationen des zentralen Nervensystems in der pädiatrischen Onkologie: retrospektive Analyse und klinische Nachuntersuchung überlebender Patienten

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161 Seiten
 
Veröffentlichung
2008-01-29
DOI
10.18725/OPARU-1360
Dissertation


Authors
Schmidt, Katrin
Faculties
Medizinische Fakultät
Peer review
ja
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Standard (Fassung vom 03.05.2003)
https://oparu.uni-ulm.de/xmlui/license_v1
Abstract
Background. Clinical studies analysing CNS complications in pediatric oncology symstematically are rare. Procedure. In a single center retrospective analysis, CNS complications in 950 subsequent pediatric patients treated between 1992 and 2004 by chemotherapy or hematopoietic stem cell transplantation (HSCT) were studied. 46 patients had pre-existing CNS diseases and were excluded. Out of the 904 remaining, 76 (8.4%) had 82 CNS complications. Results. The most common manifestations were seizures (in 50.6% of the CNS episodes), altered states of consciousness, and motor deficits (in 47.5% of the episodes each). CNS complications were caused by infections (26.8%), toxicity (25.6%), neoplasma (13.4%), vascular (10.9%) and metabolic disturbances (8.5%). In 14.6%, the mechanism remained unclear. 23.7% of the patients died from the CNS event. Neoplastic disorders had the worst (50%) while metabolic the best (0% mortality) prognosis. Imaging techniques were the most effective diagnostic measures, followed by laboratory analysis, clinical examination and CSF analysis. A neuro-psychological (CBCL, CFT-1 / -20 – testing) examination could be done in 21 of 32 long-term survivors. 7 had a major, 3 minor neurological impairment, 11 were normal in all tests. Conclusions. These data show that there is not one typical CNS complication, but a wide variety. There is no close connection between either underlying disease or symptoms and cause of the complication. Prognosis is variable. About two thirds of the long-term survivors could lead a normal life.
Date created
2007
Original publication
Pediatric blood & cancer. 2008 Feb; 50 (2): 331 - 336
10.1002/pbc.21237
Subject Headings
Zentralnervensystem [GND]
Central nervous diseases. In infancy and childhood [MeSH]
Neoplasms. In infancy and childhood [MeSH]
Keywords
Neurologische Komplikationen; ZNS-Komplikationen
Dewey Decimal Group
DDC 610 / Medicine & health

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Citation example

Schmidt, Katrin (2008): Komplikationen des zentralen Nervensystems in der pädiatrischen Onkologie: retrospektive Analyse und klinische Nachuntersuchung überlebender Patienten. Open Access Repositorium der Universität Ulm. Dissertation. http://dx.doi.org/10.18725/OPARU-1360

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