Summary:We analyzed the incidence of neurological complications in 77 patients receiving stem cell transplantation (SCT), and 12 patients (15.8%) had the following symptoms: convulsions, intracranial hemorrhage, and leukoencephalopathy. Although statistically not significant, neurological complications were seen more frequently in patients after allogeneic transplantation, and in those with acute graft-versus-host disease (GVHD) exceeding grade II. The most significant risk factor for neurological complications was identified as unrelated donor allogenic transplantation (P = 0.016). Complications were categorized into three groups, based on time of onset and symptoms: (1) convulsions during the conditioning period, (2) intracranial hemorrhage during the period of granulocyte recovery, and (3) leukoencephalopathy at around 2 months after SCT. We propose awareness of the risks of neurological complications in each period after SCT so that immediate and effective treatment of patients can be instigated.

Successive purification of a crude extract of cultured Mi Huan Jun mycelia, followed by an assay of the effect on complete ischemia in mice, led to the isolation of a new compound with cerebral protecting activity, hereafter designated as AMG-1. The structure of AMG-1 was proposed as being 6-(5-hydroxy-2-pyridyl-methylamino)-9-beta-ribofuranosylpurine (1) on the basis of its UV, mass, 1H-NMR, and 13C-NMR spectra.

Summary: Patients and methodsBetween June 1989 and November 1996, a total of 22 High-dose busulfan (BU) is widely used in combined chemotherapy before allogeneic or autologous bone patients with various hematological malignancies or immunodeficiencies received allogeneic BMT (14 cases) or marrow transplantation. Convulsions are reported as a side-effect of high-dose BU. We recorded electroenceautologous peripheral blood stem cell transplants (eight cases) after preparation with high-dose BU (Table 1). Thirphalograms (EEGs) before and on the third day of BU administration in 22 patients. Abnormal EEGs were teen patients had acute lymphoblastic leukemia (ALL): eight were in first complete remission (CR) and five were observed on the third day in 13 cases (59%). These patients were older (P Ͻ Ͻ Ͻ 0.05) and had had larger doses in second CR. Five patients had acute non-lymphoblastic leukemia (ANLL): three were in first CR and two were of BU (P Ͻ Ͻ Ͻ 0.025) than the nine patients with normal EEGs. Convulsions occurred in two of the 22 patients, in second CR. Five patients had other diseases: two nonHodgkin's lymphoma (NHL), one Wiskott Aldrich synone of whom was receiving prophylaxis with phenytoin. Gamma aminobutyric acid (GABA), a natural mediator drome (WAS), and one chronic myelogenous leukemia (CML). of defense against epileptic activity, concentrations in cerebrospinal fluid measured before and after adminis-The conditioning regimen used consisted of BU given orally over 4 consecutive days, followed by cyclophostration of BU showed no definite changes. Keywords: busulfan; convulsion; electroencephalogram; phamide (CY) and/or other drugs. The dose of BU was 16 mg/kg in older children and 500 mg/m 2 in younger chil-GABA dren. Every patient except when otherwise stated received anticonvulsant prophylaxis with phenytoin (4 mg/kg intravenously as a loading dose followed by 4 mg/kg/day High-dose busulfan (BU) is increasingly used in conditionorally). Phenytoin administration was begun 12 h before the ing regimens for bone marrow transplantation (BMT).first dose of BU and continued until at least 24 h after the Liver dysfunction is reported as a side-effect of high-dose last dose. BU. Since the introduction of high-dose BU in conditioning EEGs were recorded before, and on the third day of BU regimens for bone marrow transplantation, several cases of administration and were evaluated by pediatric neurolconvulsions have been reported, especially in adults. [1][2][3][4][5][6] In ogists. The administration of BU and phenytoin, and schedthe literature, convulsion occurs in adults after the second ule for EEG recording are illustrated in Figure 1. GABA day of therapy, more frequently after the last dose of BU.concentrations in cerebrospinal fluid samples were measPhenytoin is usually given to adult patients receiving highured in 12 of 22 patients, four with normal EEGs and eight dose BU, but convulsions still occur after prophylaxis. In with abnormal EEGs before and on the third day of BU children, the acute neurotoxicity o...

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