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Neurological complications following alemtuzumab-based reduced-intensity allogeneic transplantation.

Avivi, I; Chakrabarti, S; Kottaridis, P; Kyriaku, C; Dogan, A; Milligan, DW; Linch, D; ... Mackinnon, S; + view all (2004) Neurological complications following alemtuzumab-based reduced-intensity allogeneic transplantation. Bone Marrow Transplant , 34 (2) pp. 137-142. 10.1038/sj.bmt.1704538.

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Abstract

We report the incidence, characteristics and outcome of neurological complications occurring following reduced-intensity conditioning (RIC) in 85 patients who received a related/unrelated donor stem cell transplantation following therapy with alemtuzumab, fludarabine and melphalan. Six patients (probability 8.9%) developed severe neurological complications at a median of 151 days (24-334 days). Five of them presented with progressive peripheral sensori-motor radiculo-neuropathy and/or myelitis, preceded by one or more viral reactivation/infection. Despite treatment with immunoglobulins/plasmapheresis/steroids, four died of respiratory failure due to progressive peripheral neurophathy. Viral infection was identified as the only risk factor for the development of neurological complications. Patients who are treated with alemtuzumab-based RIC may have a lower risk of developing regimen-related neurological complications, but are more susceptible to develop peripheral radiculo-neuropathy or myelitis. This phenomenon may be possibly related to viral infection associated with delayed immunological recovery or immunological dysregulation caused by alemtuzumab-induced T-cell depletion.

Type: Article
Title: Neurological complications following alemtuzumab-based reduced-intensity allogeneic transplantation.
Location: England
DOI: 10.1038/sj.bmt.1704538
Keywords: Adolescent, Adult, Alemtuzumab, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Antibodies, Neoplasm, Antineoplastic Combined Chemotherapy Protocols, Female, Hematologic Neoplasms, Hematopoietic Stem Cell Transplantation, Humans, Incidence, Male, Melphalan, Middle Aged, Nervous System Diseases, Risk Factors, Transplantation Conditioning, Transplantation, Homologous, Vidarabine, Virus Diseases
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: http://discovery.ucl.ac.uk/id/eprint/65675
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