• Lina Xing, Shupeng Wen, Zhiyun Niu, Fuxu Wang, and Xuejun Zhang.
• Department of Hematology, Hebei Key Laboratory of Hematology, The Second Hospital of Hebei Medical University , Shijiazhuang, China.
• Postgrad Med. 2020 Jun 1; 132 (5): 485-488.

AbstractAcute demyelinating myelopathy after allogeneic hematopoietic stem cell transplantation (HSCT) is rare, and the exact pathogenesis remains unclear. Here, we report the case of a 20-year-old patient with B-cell acute lymphocyte leukemia (B-ALL) who developed acute demyelinating myelopathy approximately 10 months after HSCT. Magnetic resonance imaging revealed high T2 signal intensity lesions from the C2-T4 levels of the spinal cord. Treatments with high doses of corticosteroids, immunoglobulins, and rituximab improved his neurologic symptoms, and he achieved 44 months of leukemia-free and graft-versus-host disease (GVHD)-free survival, with no recurrence of the demyelination myelopathy. An understanding of the contribution of immune reconstitution to the pathogenesis of demyelinating myelopathy after HSCT and the association of this disease with GVHD will require more clinical cases.

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