A survey on hematology-oncology pediatric AIEOP centres: The challenge of posterior reversible encephalopathy syndrome

Daniele Zama, Pietro Gasperini, Massimo Berger, Mariagrazia Petris, Maria D. De Pasquale, Simone Cesaro, Maria E. Guerzoni, Elena Mastrodicasa, Francesca Savina, Ottavio Ziino, Valentina Kiren, Paola Muggeo, Rosa M. Mura, Fraia Melchionda, Giulio A. Zanazzo, on behalf of Supportive Therapy Working Group of Italian Pediatric Haematology and Oncology Association (AIEOP)

Research output: Contribution to journalArticlepeer-review


Objectives: Posterior reversible encephalopathy syndrome (PRES) is one of the most common neurological complications in hematology-oncology pediatric patients. Despite an increasingly recognized occurrence, no clear consensus exists regarding how best to manage the syndrome, because most cases of PRES have reported in single-case reports or small series. Aim of this paper is to identify incidence, clinical features, management, and outcome of PRES in a large series of hematology-oncology pediatric patients. Methods: The cases of PRES occurred in twelve centers of the Italian Association of Pediatric Hematology and Oncology were reported. Results: One hundred and twenty-four cases of PRES in 112 pediatric patients were recorded with an incidence of 2.1% and 4.7%, respectively, in acute lymphoblastic leukemia in first complete remission and hematopoietic stem cell transplantation (HSCT). The majority of cases occurred after a cycle of chemotherapy rather than after stem cell transplant. PRES after chemotherapy significantly differs from that after HSCT for diagnosis, time of presentation, risk factors, management, and outcome. Conclusions: This study demonstrates that PRES is a common neurological complication and occurring preferentially in course of induction treatment of some hematologic malignancies, as ALL and after HSCT. It also highlights great clinical differences in the management and outcome in patients with PRES occurring after chemotherapy or after HSCT.

Original languageEnglish
Pages (from-to)75-82
Number of pages8
JournalEuropean Journal of Haematology
Issue number1
Publication statusPublished - Jan 1 2018


  • pediatric oncology, and hematology
  • posterior reversible encephalopathy syndrome

ASJC Scopus subject areas

  • Hematology


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