title: Immune-mediated myelopathy following allogeneic stem cell transplantation.
abstract: We report a case of immune-mediated myelopathy occurring 4 months after unrelated bone marrow transplantation for myelodysplastic syndrome. After the tapering of cyclosporine for graft-versus-host disease prophylaxis, the patient developed several neurological symptoms mimicking the clinical features of multiple sclerosis (MS). Although neurological exacerbation was well stabilized with a bulk dose of corticosteroid, sustained improvement of neurological deficits occurred after the patient developed hematopoietic mixed chimerism (HMC). This experience may provide clinical evidence supporting the current therapeutic concept, in which HMC induction can potentially cure several immune diseases, including MS.
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Sakai
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.forename: Keiko
authors.initials: K
authors.lastname: Ohta
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hideki
authors.initials: H
authors.lastname: Akiyama
authors.forename: Shuji
authors.initials: S
authors.lastname: Kisida
authors.forename: Noriko
authors.initials: N
authors.lastname: Kamata
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008775:Methylprednisolone / Q000008:administration & dosage*; D009190:Myelodysplastic Syndromes / Q000150:complications; D010198:Pancytopenia / Q000150:complications / Q000628:therapy; D013118:Spinal Cord Diseases / Q000188:drug therapy* / Q000209:etiology; D033581:Stem Cell Transplantation / Q000009:adverse effects; D018183:Transplantation Chimera; D014184:Transplantation, Homologous
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008775:Methylprednisolone