A Case of Central Nervous System Myelomatosis Developing after Allogeneic Hematopoietic Stem Cell Transplantation.
10.5045/kjh.2008.43.3.194
- Author:
Gak Won YUN
1
;
Ik Chan SONG
;
Seon Ah JIN
;
Young Joon YANG
;
Nam Hwan PARK
;
Hyo Jin LEE
;
Hwan Jung YUN
;
Samyong KIM
;
Deog Yeon JO
Author Information
1. Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Korea. deogyeon@cnu.ac.kr
- Publication Type:Case Report
- Keywords:
Multiple myeloma;
CNS myelomatosis;
Allogeneic stem cell transplantation;
Intra-thecal chemotherapy
- MeSH:
Antilymphocyte Serum;
Bone Marrow;
Central Nervous System;
Cytarabine;
Dexamethasone;
Female;
Hematopoietic Stem Cell Transplantation;
Hematopoietic Stem Cells;
Humans;
Light;
Lower Extremity;
Melphalan;
Methotrexate;
Middle Aged;
Multiple Myeloma;
Nervous System;
Peripheral Blood Stem Cell Transplantation;
Plasma Cells;
Transplantation, Homologous;
Transplants;
Vidarabine
- From:Korean Journal of Hematology
2008;43(3):194-197
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Central nervous system (CNS) myelomatosis, which is the presence of monoclonal plasma cells in the cerebrospinal fluid (CSF), is extremely rare. We report a case of CNS myelomatosis developed in a 45-year-old woman with multiple myeloma in complete response, which was achieved by allogeneic peripheral blood stem cell transplantation using a reduced-intensity conditioning regimen consisting of melphalan, fludarabine, and antithymocyte globulin. Two months after the transplant, she developed a moderate motor and sensory weakness in both lower extremities. Atypical plasma cells were found in the CSF, and immunofixation revealed monoclonal light chain in the CSF. She was given three courses of weekly intra-thecal chemotherapy consisting of methotrexate, cytarabine, and dexamethasone, which cleared the CSF. This case indicates that the allogeneic transplantation could not control CNS myelomatosis, despite successfully treating the bone marrow myeloma.
