[Successful treatment with rituximab in acute disseminated encephalomyelitis with whole spinal cord involvement following HLA haploidentical transplantation].

Abstract

Chronic graft versus host disease (cGVHD) of the central nervous system is a rare condition that could occur after allogeneic hematopoietic stem cell transplantation (SCT) but has been poorly documented. Here, we report a patient diagnosed with recurrent acute disseminated encephalomyelitis (ADEM) with longitudinal extensive transverse myelitis (LETM) as cGVHD after HLA haploidentical peripheral blood SCT using posttransplantation cyclophosphamide for mixed-phenotype acute leukemia. We observed clinical and radiological improvement after the rituximab treatment of the condition that had been refractory to steroids. To the best of our knowledge, no report of cGVHD presented recurrent ADEM with LETM after allogeneic SCT and successfully treated with rituximab. Hence, ADEM should be included in the differential diagnosis of neurological symptoms in posttransplant patients with cGVHD.

• Authors: Yosuke Makuuchi, Mitsutaka Nishimoto, Keiichi Yamamoto, Toshiyuki Takahashi, Masatomo Kuno, Yasuhiro Nakashima, Hideo Koh, Takahiko Nakane, Masayuki Hino, Hirohisa Nakamae
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) 2018 Vol. 59 Issue 12 Pg. 2588-2593 ISSN: 0485-1439 [Print] Japan
• PMID: 30626794 (Publication Type: Case Reports, Journal Article)

Chemical References

• Rituximab

Topics

• Diagnosis, Differential
• Encephalomyelitis, Acute Disseminated (drug therapy)
• Graft vs Host Disease
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Rituximab (therapeutic use)
• Spinal Cord (pathology)
• Transplantation, Haploidentical (adverse effects)