Cervical epidural hematoma in a healthy donor presenting stroke mimic symptoms: a rare adverse event following peripheral blood stem cell apheresis

• Published in: Japanese journal of clinical oncology Vol. 45; no. 6; pp. 584 - 587
• Main Authors: Terabe, Satomi, Nishiwaki, Satoshi, Koyama, Daisuke, Okuno, Shingo, Harada, Yasuhiko, Tomita, Hiroyuki, Yoshihara, Hisatake, Iwasaki, Toshihiro, Sugiura, Isamu
• Format: Journal Article
• Language: English
• Published: England 01.06.2015
• Subjects: Blood Component Removal - adverse effects; Cervical Vertebrae; Diagnosis, Differential; Female; Hematoma, Epidural, Spinal - complications; Hematoma, Epidural, Spinal - diagnosis; Hematoma, Epidural, Spinal - etiology; Humans; Laminectomy; Living Donors; Magnetic Resonance Imaging; Middle Aged; Neck Pain - etiology; Shoulder Pain - etiology; Stem Cells; Stroke - diagnosis; Tomography, X-Ray Computed; healthy donor; PBSC apheresis; adverse event; cervical epidural hematoma
• ISSN: 0368-2811; 1465-3621
• DOI: 10.1093/jjco/hyv034

Peripheral blood stem cell apheresis from a healthy donor is indispensable for allogeneic peripheral blood stem cell transplantation. Here, we report a rare adverse event following peripheral blood stem cell apheresis. A female sibling donor, aged 61 years with an unremarkable medical history, complained of pain in the left neck and shoulder and numbness in the left upper limb 1 h after the end of peripheral blood stem cell apheresis. Paralysis of the left upper and lower limbs appeared consecutively. Computed tomography and magnetic resonance imaging of the head showed no abnormalities. Anticoagulant therapy was initiated according to the standard treatment of atherothrombotic brain infarction. Magnetic resonance imaging of the cervical cord on the following day revealed a cervical epidural hematoma. An emergency C4-C5 laminectomy was performed, and the paralysis was improved immediately after surgery. This report is the first case of cervical epidural hematoma in a healthy donor who underwent peripheral blood stem cell apheresis and presented symptoms confusingly similar to those of brain infarction.