Guillain-Barré syndrome after allogeneic hematopoietic stem cell transplantation.
Guillain-Barré syndrome is a rare complication in the setting of hematopoietic stem cell transplantation. We report three children with T cell lymphoma/leukemia in whom this syndrome developed soon after they received unrelated donor transplants. The rapid onset of symptoms raises the concern that the bone marrow transplant conditioning regimen (ie, total body irradiation, cyclophosphamide and cytosine arabinoside) might have precipitated the clinical syndrome of ascending polyneuropathy. Although central nervous system toxicity has been well described with high-dose cytosine arabinoside therapy, peripheral neuropathy of the Guillain-Barré type has been reported only infrequently. We review possible factors contributing to the development of this syndrome in these three patients.
Rodriguez
V
V
Center for Cell and Gene Therapy, Texas Children's Hospital, Houston, TX, USA.
Kuehnle
I
I
Heslop
H E
HE
Khan
S
S
Krance
R A
RA
D000293:Adolescent; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D003561:Cytarabine / Q000009:adverse effects / Q000627:therapeutic use; D017809:Fatal Outcome; D020275:Guillain-Barre Syndrome / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015458:Leukemia, T-Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000821:virology; D016399:Lymphoma, T-Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D010222:Parainfluenza Virus 1, Human / Q000276:immunology / Q000302:isolation & purification; D010253:Respirovirus Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation / Q000009:adverse effects / Q000379:methods
D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D003561:Cytarabine; D003520:Cyclophosphamide