Acute neuropathies after peripheral blood stem cell and bone marrow transplantation.
Neuromuscular complications are not uncommon after bone marrow and stem cell transplantation, especially in patients with allogeneic transplantations and graft-versus-host disease. The pathogenesis of these complications remains unclear, but the changes in immune modulation that occur after transplantation are likely to play a key role. We describe 4 patients who developed brachial plexopathy (3 cases) or multiple lumbosacral radiculopathies (1 case) between 5 days and 4 months after autologous peripheral blood stem cell (3 cases) or allogeneic bone marrow transplantation without evidence of graft-versus-host disease (1 case). Infectious, tumor-related, toxic, and metabolic causes were excluded in all cases. Recovery was limited in two cases and nearly complete in the other two patients. Brachial plexopathies and polyradiculopathies are potential complications of peripheral blood stem cell and bone marrow transplantation. It is possible that these disorders may be the result of autoimmune phenomena directed against specific nerve antigens.
Rabinstein
Alejandro A
AA
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Dispenzieri
Angela
A
Micallef
Ivana N
IN
Inwards
David J
DJ
Litzow
Mark R
MR
Wijdicks
Eelco F M
EF
D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D004576:Electromyography; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000628:therapy; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000628:therapy; D009431:Neural Conduction / Q000502:physiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology*