Boiron J M, Ellie E, Vital A, Marit G, Rème T, Vital C, Broustet A, Reiffers J
Unité de Greffe de Moëlle, Hopital Haut-Lévêque, C.H.R. Bordeaux, France.
Leukemia. 1994 Feb;8(2):322-6.
We report a case of peripheral neuropathy occurring after autologous blood stem cell transplantation (ABSCT) for multiple myeloma. The patient, free of neurological symptoms, was transplanted in partial remission, and achieved a complete remission after transplantation. A severe peripheral, symmetric, distal sensori-motor polyneuropathy appeared at day 25 and worsened progressively until commencement of corticosteroid therapy. A peripheral nerve biopsy showed endoneurial cellular infiltrates which were predominantly composed of T cells identified by immunocytochemistry. Ultrastructural examination showed acute axonal damage. Electrophysiologic studies performed before and during the treatment were consistent with a severe axonal degeneration and showed a marked improvement, concomitant with the favorable clinical outcome. This is the first report of peripheral neuropathy after ABSCT.
我们报告了1例多发性骨髓瘤患者在自体造血干细胞移植（ABSCT）后发生周围神经病变的病例。该患者在移植时处于部分缓解状态，无神经症状，移植后达到完全缓解。在第25天时出现严重的周围性、对称性、远端感觉运动性多发性神经病变，并逐渐加重，直至开始使用皮质类固醇治疗。周围神经活检显示神经内膜细胞浸润，免疫细胞化学鉴定主要由T细胞组成。超微结构检查显示急性轴索损伤。治疗前及治疗期间进行的电生理研究结果与严重的轴索性变性一致，且随着临床症状的好转有明显改善。这是ABSCT后发生周围神经病变的首例报告。
