Neurological Complications with Paraplegia as Main Manifestation after Hematopoietic Stem Cell Transplantation

Abstract

To investigate the cause, diagnosis and therapeutic method of the neurological complication with the main manifestation of paraplegia after the hematopoietic stem cell transplantation (HSCT). The clinical features, the process of diagnosis and treatment and the prognosis follow-up of 9 cases, who received HSCT in our department during January 2014 and January 2017 and had the neurological complication with the main symptom of paraplegia after the transplantation, were summarized. The incidence rate of paraplegia was 2.96% (9/304). The median onset time was 245 days (50 days-772 days) after transplantation. The cause of paraplegia determined by examination was extramedullary recurrence of leukemia in 3 cases, cyclosporin neurotoxicity in 1 case, GBS in 1 case, CIDP in 2 cases and autoimmune myeleterosis in 2 cases. One patient abandoned the treatment. The rest 8 patients received empirical or targeted treatment. The median follow-up period was 11 months. There were 5 dead cases and 4 survival cases. Paraplegia is a serious post-HSCT complication. The cause of paraplegia should be determined as early as possible to perform targeted treatment. Empirical preemptive treatment should be given if necessary, so as to improve the survival rate and the quality of life of HSCT patients.