Immune-mediated myelopathy following allogeneic stem cell transplantation.
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.
Sakai
Miwa
M
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Ohashi
Kazuteru
K
Ohta
Keiko
K
Yamashita
Takuya
T
Akiyama
Hideki
H
Kisida
Shuji
S
Kamata
Noriko
N
Sakamaki
Hisashi
H
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
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008775:Methylprednisolone