Neuropathy and Muscle Cramps in Autologous and Allogeneic Hematopoietic Cell Transplantation Survivors

International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update

“…Late neurologic dysfunction after HCT may affect the central nervous system (CNS) and peripheral nervous system and are more frequent after allogeneic HCT ( Table 10 , Supplementary Table S14 ) [ 235 – 237 ]. Potential causes include infection or immunosuppression (with CNIs), neurotoxic chemotherapy (eg, methotrexate, cytarabine, busulfan, thiotepa) and other medications, TA-TMA, cranial radiation or TBI, radiation-induced vasculitis, underlying disease (eg, cerebrovascular disease, sickle cell disease, adenosine deaminase deficiency), CNS relapse of the original disease, PTLD, subsequent neoplasms (local effects or paraneoplastic syndromes) and, finally by exclusion, cGVHD [ 238 ].…”

“…Similarly, up to half of survivors report sleep disturbance that does not seem to improve over time, and has been associated with female gender, older age, divorced status, unemployment, depression, distress, and autologous HCT [ 12 ]. Pain is reported among ~25% of survivors, often associated with musculoskeletal symptoms [ 12 , 237 , 269 ].…”

Long-term health outcomes of allogeneic hematopoietic stem cell transplantation

“…Muscle cramps and myalgia are common late complications after HCT. In a cross-sectional study of 1745 patients who underwent transplantation, neuropathies were reported in 66% with cGVHD, with the majority reporting muscle cramps ( 54 ). In another retrospective study, clinical signs of polyneuropathy, including both proximal and distal limb distribution with sensory and motor deficits, were evident at a median of 6 months in survivors with cGVHD ( 55 ).…”