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[急性淋巴细胞白血病异基因骨髓移植后急性横贯性脊髓炎——一例报告]

[Acute transverse myelitis after allogeneic bone marrow transplantation for acute lymphoblastic leukemia--a case report].

作者信息

Manabe Masahiro, Nishimoto Mitsutaka, Ito Kazuhiro, Okamura Hiroshi, Bingo Masato, Yoshida Masahiro, Inoue Atsushi, Aimoto Mizuki, Hayashi Yoshiki, Koh Hideo, Nakane Takahiko, Nakamae Mika, Terada Yoshiki, Nakamae Hirohisa, Nakao Takafumi, Koh Ki-Ryang, Hirai Manabu, Nakao Yoshitaka, Yamane Takahisa, Hino Masayuki

机构信息

Dept. of Hematology, Osaka City University,

出版信息

Gan To Kagaku Ryoho. 2013 Apr;40(4):529-32.

Abstract

Transverse myelitis is an inflammatory disorder of the spinal cord that results in motor, sensory, and autonomic dysfunction. Herein, we describe a 40-year-old Japanese female who developed acute transverse myelitis (ATM) after an unrelated bone marrow transplantation for Philadelphia-positive acute lymphoblastic leukemia in molecular complete remission. Approximately 90 days after transplantation, she suffered from paresthesias, sphincter dysfunction, and lower extremity weakness. Spinal cord magnetic resonance imaging scan demonstrated findings consistent with ATM. The symptoms were resolved with the administration of steroids, followed by intravenous immunoglobulin therapy for a few sequelae. To the best of our knowledge, the presentation of ATM after hematopoietic stem cell transplantation is relatively rare. As the functional prognosis of ATM depends on prompt diagnosis and treatment, we consider that ATM should be included in the differential diagnosis of post-transplant myelopathies.

摘要

横贯性脊髓炎是一种脊髓炎症性疾病,可导致运动、感觉和自主神经功能障碍。在此,我们描述一名40岁的日本女性,她在因分子学完全缓解的费城染色体阳性急性淋巴细胞白血病接受无关供者骨髓移植后发生了急性横贯性脊髓炎(ATM)。移植后约90天,她出现感觉异常、括约肌功能障碍和下肢无力。脊髓磁共振成像扫描显示的结果与ATM相符。症状通过使用类固醇得到缓解,随后针对一些后遗症进行了静脉注射免疫球蛋白治疗。据我们所知,造血干细胞移植后出现ATM的情况相对罕见。由于ATM的功能预后取决于及时诊断和治疗,我们认为在移植后脊髓病的鉴别诊断中应考虑到ATM。

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