Guillain-Barré syndrome complicating mobilization therapy in a case of B-cell chronic lymphocytic leukemia

Leuk Lymphoma. 2004 Jul;45(7):1489-90. doi: 10.1080/10428190410001672149.

Abstract

We report a case of Guillain-Barré Syndrome (GBS) which appeared after mobilization therapy in a patient with B-cell chronic lymphocytic leukemia (B-CLL). After obtaining a partial remission with four cycles of fludarabine at standard dose, the patient underwent to high-dose Cytoxan in order to mobilize CD34+ hematopoietic progenitor cells. During neutropenia the patient experienced fever of unknown origin (FUO) and subsequently developed GBS with normalization of his neurologic condition after 2 months. It is possible that a viral-induced activation of an antigen-specific T and B-cell clone caused a local inflammation and toxicity of Schwann cells with demyelination and axonal damage with a self-limited course.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / pharmacology
  • Fever of Unknown Origin / complications
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / pharmacology
  • Guillain-Barre Syndrome / etiology*
  • Hematopoietic Stem Cell Mobilization*
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy*
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation / adverse effects*
  • Recombinant Proteins
  • Transplantation, Autologous
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives*

Substances

  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Cyclophosphamide
  • Vidarabine
  • fludarabine
  • Filgrastim