Risk factors for seizures after hematopoietic stem cell transplantation in pediatric hemato-oncologic patients: A single tertiary center study in the republic of korea

Purpose: The aim of this study was to assess the incidence of seizures, clinical manifestations, and risk factors that could predict the occurrence of seizures after hematopoietic stem cell transplantation (HSCT) in children. Methods: The study group consisted of 543 patients (311 males and 232 females) registered at the Catholic University of Korea’s Seoul St. Mary’s Hospital who received HSCT before the age of 18 from January 2009 to January 2019. Their medical records and test results were retrospectively reviewed. Results: The incidence of seizure after HSCT was 6.6% and the average age of seizure patients was 8.33±5.5 years. The use of calcineurin inhibitors combined with methotrexate as prophylaxis for graft versus host disease (GVHD) was a statistically significant risk factor for seizures (P=0.006). Pediatric patients with grade 2–4 acute GVHD (P=0.003) also showed a higher incidence of seizures than those with grade 0–1 acute GVHD after HSCT. Conclusion: Our findings indicate that among pediatric patients who underwent HSCT, using calcineurin inhibitors with methotrexate as a conditioning regimen and a higher grade (≥2) of acute GVHD are risk factors of seizures.