Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Brachial plexopathy following high-dose melphalan and autologous peripheral blood stem cell transplantation

Bone Marrow Transplantation volume 45, pages 951–952 (2010)Cite this article

Neuromuscular pathologies are a recognized complication of SCT, often occurring as a result of infection or haemorrhage, but also in association with GVHD following allogeneic SCT.1 The published literature on post-transplant peripheral nervous system pathologies includes descriptions of myasthenia gravis, Guillain-Barré syndrome, polymyositis and peripheral neuropathy.2, 3, 4, 5 Ocular toxicity, radiculopathy and plexopathy have also rarely been reported. We report three cases of brachial plexopathy occurring after autologous peripheral blood stem cell transplantation (PBSCT).

A 64-year-old man was initially treated with adriamycin, carmustine, CY and melphalan for symptomatic multiple myeloma. Following a poor response the patient was switched to oral melphalan, which was continued for 6 months. At first progression, 4 years later, chemotherapy was restarted with VCR, CY, doxorubicin and methylprednisolone . This was followed by an autologous PBSCT with high-dose melphalan (200 mg/m2) conditioning.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Antonini G, Ceschin V, Morino S, Fiorelli M, Gragnani F, Mengarelli A et al. Early neurologic complications following allogeneic bone marrow transplant for leukemia: a prospective study. Neurology 1998; 50: 1441–1445.

    Article  CAS  PubMed  Google Scholar 

  2. Rabinstein AA, Dispenzieri A, Micallef IN, Inwards DJ, Litzow MR, Wijdicks EF . Acute neuropathies after peripheral blood stem cell and bone marrow transplantation. Muscle Nerve 2003; 28: 733–736.

    Article  PubMed  Google Scholar 

  3. Rodriguez V, Kuehnle I, Heslop HE, Khan S, Krance RA . Guillain-Barré syndrome after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2002; 29: 515–517.

    Article  CAS  PubMed  Google Scholar 

  4. Baron F, Sadzot B, Wang F, Beguin Y . Myasthenia gravis without chronic GVHD after allogeneic bone marrow transplantation. Bone Marrow Transplant 1998; 22: 197–200.

    Article  CAS  PubMed  Google Scholar 

  5. Couriel DR, Beguelin GZ, Giralt S, De Lima M, Hosing C, Kharfan-Dabaja MA et al. Chronic graft-versus-host disease manifesting as polymyositis: an uncommon presentation. Bone Marrow Transplant 2002; 30: 543–546.

    Article  CAS  Google Scholar 

  6. Openshaw H . Peripheral neuropathy after bone marrow transplantation. Biol Blood Marrow Transplant 1997; 3: 202–209.

    CAS  PubMed  Google Scholar 

  7. Mileshkin L, Stark R, Day B, Seymour JF, Zeldis JB, Prince HM . Development of neuropathy in patients with myeloma treated with thalidomide: patterns of occurrence and the role of electrophysiologic monitoring. J Clin Oncol 2006; 24: 4507–4514.

    Article  CAS  PubMed  Google Scholar 

  8. Plasmati R, Pastorelli F, Cavo M, Petracci E, Zamagni E, Tosi P et al. Neuropathy in multiple myeloma treated with thalidomide: a prospective study. Neurology 2007; 69: 573–581.

    Article  CAS  PubMed  Google Scholar 

  9. Sierra A, Prat J, Bas J, Romeu A, Montero J, Matos JA et al. Blood lymphocytes are sensitized to branchial plexus nerves in patients with neuralgic amyotrophy. Acta Neurol Scand 1991; 83: 183–186.

    Article  CAS  PubMed  Google Scholar 

  10. Suarez GA, Giannini C, Bosch EP, Barohn RJ, Wodak J, Ebeling P et al. Immune brachial plexus neuropathy: suggestive evidence for an inflammatory-immune pathogenesis. Neurology 1996; 46: 559–561.

    Article  CAS  PubMed  Google Scholar 

  11. Porrata LF, Litzow MR, Markovic SN . Immune reconstitution after autologous hematopoietic stem cell transplantation. Mayo Clin Proc 2001; 76: 407–412.

    Article  CAS  PubMed  Google Scholar 

  12. Daikeler T, Tyndall A . Autoimmunity following haematopoietic stem-cell transplantation. Best Pract Res Clin Haematol 2007; 20: 349–360.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Queens Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, East Yorkshire, UK

    C Parrish, R Patmore, M Shields & D Allsup

  2. Department of Neurology, Hull Royal Infirmary, Hull, UK

    A Ming

Authors
  1. C Parrish
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A Ming
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R Patmore
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Shields
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D Allsup
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C Parrish.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Parrish, C., Ming, A., Patmore, R. et al. Brachial plexopathy following high-dose melphalan and autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 45, 951–952 (2010). https://doi.org/10.1038/bmt.2009.243

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2009.243

This article is cited by

Search

Advanced search

Quick links