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