Steroid-responsive cauda equina syndrome associated with GVHD after allogeneic hematopoietic stem cell transplantation

Terrettaz, Marianne; Verholen, Fabienne; Passweg, Jakob; Knipp, S.; Burkhard, Pierre; Chalandon, Yves

doi:10.1038/sj.bmt.1705915

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…There have also been reports of the use of intrathecal steroids for CNS‐GVHD after allogeneic hematopoietic stem cell transplantation with mixed results . Although there are several retrospective studies and reports of different treatment modalities, there are no direct comparisons between withdrawal and intensification of immunosuppression . In the reported case, we stopped immunosuppression except for steroids.…”

Section: Discussionmentioning

confidence: 91%

“…A recent review of literature involved 34 patients (not involving LT recipients) with CNS‐GVHD who were treated with immunosuppressive therapy, including corticosteroids, intravenous immunoglobulin, plasmapheresis, cyclophosphamide, calcineurin inhibitors, mycophenolic acid, methotrexate, and etoposide, with 10 achieving complete and 15 more achieving partial responses . There have also been reports of the use of intrathecal steroids for CNS‐GVHD after allogeneic hematopoietic stem cell transplantation with mixed results . Although there are several retrospective studies and reports of different treatment modalities, there are no direct comparisons between withdrawal and intensification of immunosuppression .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Graft-versus-host disease of the central nervous system after liver transplantation: A rare complication

Pahari

Nagai

Skorupski

et al. 2018

American Journal of Transplantation

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Graft-versus-host disease (GVHD) of the central nervous system (CNS) following solid organ transplantation is a rare but serious complication and has been previously reported after bone marrow transplantation. GVHD after liver transplantation is a rare entity with a high mortality rate. We report the case of a patient who developed GVHD and subsequently had seizures and altered mental status after deceased donor liver transplantation. The diagnosis of GVHD of the CNS was established by short tandem repeat loci analysis of the cerebrospinal fluid using the polymerase chain reaction technique and gene mapping software. To our knowledge, this is the first reported case of CNS-GVHD following liver transplantation. He eventually died of sepsis and multiorgan failure, in keeping with the overall poor prognosis of CNS-GVHD.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Graft-versus-host disease of the central nervous system after liver transplantation: A rare complication

Pahari

Nagai

Skorupski

et al. 2018

American Journal of Transplantation

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“…Previous cases reported in the literature were most often treated by corticosteroid pulses6 or by intrathecal corticosteroid therapy5 with, in most cases, favourable response to the treatment. In progressive cases, an increase in systemic immunosuppressive therapy or rituximab treatment may be beneficial 23.…”

Section: Discussionmentioning

confidence: 99%

Central nervous system graft-versus-host disease (CNS-GvHD) after allogeneic haematopoietic stem cell transplantation

et al. 2018

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A 60-year-old man presented with impaired consciousness and psychomotor agitation after a second allogeneic haematopoietic stem cell transplantation (HSCT) from a matched unrelated donor for acute myeloid leukaemia. Clinical, biological and radiological evidence suggested a diagnosis of central nervous system graft-versus-host disease (CNS-GvHD). After intrathecal infusion of methylprednisolone, the clinical symptoms as well as the radiological abnormalities disappeared. The present report illustrates the difficulties in the diagnosis and the management of CNS-GvHD, a very rare and still challenging neurological complication that can occur after allogeneic HSCT.

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Successful treatment of meningeal graft-versus-host disease in a haematopoietic stem cell transplant recipient

Pechey

Parratt

et al. 2014

Int J Hematol

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Graft-versus-host disease (GVHD) of the central nervous system is a rare complication following allogeneic haematopoietic stem cell transplant (HSCT). It is a challenging disease process to confirm as biopsies of the involved tissues can be difficult to obtain safely, the clinical presentation can be non-specific and the differential diagnosis includes infection, drug toxicities, metabolic encephalopathy and disease relapse. We report a case of meningeal graft-versus-host disease in a young woman with relapsed acute myeloid leukaemia after a sibling allogeneic HSCT. The GVHD responded to immunosuppression with resolution of the clinical symptoms and radiological findings and has remained quiescent after a second allogeneic HSCT from an unrelated matched donor.

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Steroid-responsive cauda equina syndrome associated with GVHD after allogeneic hematopoietic stem cell transplantation

Cited by 6 publications

References 9 publications

Graft-versus-host disease of the central nervous system after liver transplantation: A rare complication

Graft-versus-host disease of the central nervous system after liver transplantation: A rare complication

Central nervous system graft-versus-host disease (CNS-GvHD) after allogeneic haematopoietic stem cell transplantation

Successful treatment of meningeal graft-versus-host disease in a haematopoietic stem cell transplant recipient

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