title: Melphalan Culprit or Confounder in Acute Encephalopathy during Autologous Hematopoietic Stem Cell Transplantation?
abstract: We report a case of a female patient with Durie-Salmon stage 3A/ISS stage I IgG kappa multiple myeloma (MM) who developed encephalopathy after high-dose melphalan and hematopoietic stem cell transplant (HSCT). The most common etiologies for encephalopathy such as infection, narcotic medications, metabolic-electrolyte disturbance, stroke, and central nervous system (CNS) hemorrhages were ruled out. The patient recovered from the altered mental status spontaneously. The possibilities of melphalan-induced encephalopathy versus critical-state delirium versus hypercytokinemia induce encephalopathy were contemplated.
authors.affiliation: Hematology-Oncology Program San Juan City Hospital and VA Caribbean Healthcare System, 10 Calle Casia, San Juan, PR 00921, USA.
authors.forename: Diógenes
authors.initials: D
authors.lastname: Alayón-Laguer
authors.forename: Melissa
authors.initials: M
authors.lastname: Alsina
authors.forename: Jose L
authors.initials: JL
authors.lastname: Ochoa-Bayona
authors.forename: Ernesto
authors.initials: E
authors.lastname: Ayala