Guillain-Barré syndrome following allogeneic bone marrow transplantation

Abstract

We describe four patients who developed Guillain-Barré syndrome (GBS) following allogeneic bone marrow transplantation (BMT). All four patients had a febrile illness before developing GBS. Two patients had mild graft-versus-host disease but did not require immunosuppression. These patients add to the increasing number of BMT patients whose courses have been complicated by GBS and raise the possibility that BMT patients, especially those undergoing allogeneic BMT, may have a higher risk of developing GBS.

Rituximab-responsive Guillain–Barré syndrome following allogeneic hematopoietic SCT

“…1,2 We describe the case of a patient who developed GBS after T-celldepleted HSCT (TCD-HSCT) for myelodysplastic syndrome (MDS). EBV reactivation occurred concomitantly.…”

Immune-mediated motor polyneuropathy after hematopoietic stem cell transplantation

“…1,[4][5][6][7][8][9][10] The clinical characteristics of the patients with GBS and CIDP are shown in Table 1. There were no differences between the two groups in demographic features, including primary diseases and conditionings or transplant procedures.…”

Neurological complications following alemtuzumab-based reduced-intensity allogeneic transplantation

“…Another patient who developed axonal type GBS (patient 2) had no clinical symptoms of GVHD, but a sural nerve biopsy showed axonal degeneration with a significant infiltration of plasma cells, histological features that may fit with cGVHD of the PNS. 22 There are some more evidences supporting the existence of cGVHD in the PNS: 4,7,22 Firstly, the concurrent exacerbation of neurological symptoms and gut or liver GVHD, and secondly, an infiltration of plasma cells or lymphocytes in peripheral nerves, a phenomenon of immunological damage. However, despite the relatively high frequency of classical GBS/GBS subtypes observed with alemtuzumab-based RISCT, cGVHD itself was less frequent than observed with conventional allograft.…”

“…[1][2][3][4] However, severe neurological complications involving the peripheral nervous system (PNS) are relatively rare, occurring in less than 3% of transplanted patients and presents with acute or chronic inflammatory demyelinating polyneuropathy. 2,[4][5][6][7][8] An alternative approach for allogeneic SCT, aimed at attenuating treatment-related toxicity by reducing the conditioning chemotherapy dose and increasing the cure rate by inducing a graft-versus-tumour effect, has recently been introduced in patients with haematological malignancies. [9][10][11][12] We describe the incidence, characteristics and outcome of neurological complication following alemtuzumab-based reduced-intensity SCT (RISCT), emphasizing the relatively high incidence of PNS involvement observed in these patients.…”