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Cryptococcal meningitis following autologous stem cell transplantation in a patient with multiple myeloma

Bone Marrow Transplantation volume 30, pages 259–260 (2002)Cite this article

Multiple myeloma (MM) is incurable, except in some younger patients who undergo allogeneic bone marrow transplantation. However, the clinical outcome of patients with MM has improved significantly over the past 10 years with the use of high-dose chemotherapy and autologous stem cell transplantation (autoSCT).1 Infection is one of the most common complications in patients with MM undergoing autoSCT. The vast majority of infectious complications are caused by bacteria, viruses and fungi, such as aspergillus species or candida species.2 To our knowledge, cryptococcosis has never been reported in patients undergoing autoSCT for the treatment of any diseases, including MM.

A 42-year-old white woman was diagnosed with stage III-B MM (IgGκ) by a serum monoclonal spike of 13 g/dl and 80% plasma cells in the bone marrow. She received three cycles of vincristine, doxorubicin and dexamethasone (VAD) with a good response. AutoSCT was recommended since she did not have an HLA-matched sibling. Stem cells were mobilized with cyclophosphamide 5.0 g/m2 i.v. and 20 × 106/kg CD34+ cells were harvested in February 2001. She underwent an autoSCT after receiving melphalan 200 mg/m2 in April 2001. The patient engrafted promptly and did not develop any major complications in the immediate post-transplant period. She received fluconazole, ciprofloxacin and acyclovir prophylaxis from day +1 post-transplant until neutrophil recovery. Her M-spike decreased significantly to 1.9 g/dl, and bone marrow aspirate/biopsy revealed no increase in plasma cells.

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Authors and Affiliations

  1. Department of Internal Medicine, Medical College of Georgia, Section of Hematology/Oncology, Augusta, GA, USA

    SD Mendpara, C Ustun, AM Kallab, PA Bilodeau & AP Jillella

  2. Department of Pathology, Medical College of Georgia, Augusta, GA, USA

    FM Mazzella

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  1. SD Mendpara
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  2. C Ustun
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  3. AM Kallab
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Mendpara, S., Ustun, C., Kallab, A. et al. Cryptococcal meningitis following autologous stem cell transplantation in a patient with multiple myeloma. Bone Marrow Transplant 30, 259–260 (2002). https://doi.org/10.1038/sj.bmt.1703646

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