title: Guillain-Barré syndrome complicating mobilization therapy in a case of B-cell chronic lymphocytic leukemia.
abstract: We report a case of Guillain-Barré Syndrome (GBS) which appeared after mobilization therapy in a patient with B-cell chronic lymphocytic leukemia (B-CLL). After obtaining a partial remission with four cycles of fludarabine at standard dose, the patient underwent to high-dose Cytoxan in order to mobilize CD34+ hematopoietic progenitor cells. During neutropenia the patient experienced fever of unknown origin (FUO) and subsequently developed GBS with normalization of his neurologic condition after 2 months. It is possible that a viral-induced activation of an antigen-specific T and B-cell clone caused a local inflammation and toxicity of Schwann cells with demyelination and axonal damage with a self-limited course.
authors.affiliation: Department of Internal Medicine, S Luca Hospital, Vallo della Lucania (Sa), Italy. giovannidarena@libero.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: D'Arena
authors.forename: Maria Luigia
authors.initials: ML
authors.lastname: Vigliotti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pizza
authors.forename: Alfredo
authors.initials: A
authors.lastname: Tartarone
authors.forename: Giampiero
authors.initials: G
authors.lastname: Volpe
authors.forename: Giovanni
authors.initials: G
authors.lastname: Iodice
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Renzo
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000494:pharmacology; D005335:Fever of Unknown Origin / Q000150:complications; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D020275:Guillain-Barre Syndrome / Q000209:etiology*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011994:Recombinant Proteins; D014182:Transplantation, Autologous; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine; D000069585:Filgrastim