Transient focal neurologic deficits upon hematopoietic stem cell transplantation: just a coincidence?
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The infusion of hematopoietic stem cells cryopreserved with dimethylsulfoxide (DMSO) has rarely been associated with neurologic adverse events including stroke, seizures, and encephalopathy . Here, we report a challenging case of acute transient brainstem dysfunction upon DMSO-cryopreserved hematopoietic stem cell transplantation (HSCT).
A 67-year-old man, diagnosed with plasma cell myeloma, was admitted for his first autologous HSCT. He had previously received induction chemotherapy including thalidomide and lenalidomide. His cardiovascular risk factors were atrial flutter treated with apixaban, hypertension, and past smoking. On the day before HSCT, he was conditioned with high-dose melphalan, and apixaban was paused due to expected thrombocytopenia. HSCT consisted of a 157 mL infusion of CD34+ cells cryopreserved using 7.5% DMSO. Five minutes after his otherwise uneventful HCST, he became somnolent and developed a right-sided facial droop. An urgent...
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Conflict of interest
AAP, GTS, and MM report no conflicts of interest. GMDM has been supported by the following Grants: Swiss National Science Foundation; Swisslife Jubiläumsstiftung for Medical Research; Swiss Neurological Society; Bangerter-Rhyner-Stiftung; Fondazione Dr. Ettore Balli (Switzerland); travel honoraria by Bayer; De Quervain research Grant for young clinical investigators of the Clinical Trial Unit, University of Bern (Switzerland).
No targeted funding reported.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent for publication was obtained from the individual patient.
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