Grand Rounds - Hammersmith Hospital: Clinicopathological conference Dizziness and confusion after bone marrow transplantation

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Abstract
DOS: A 44 year old woman, who had received a bone marrow transplant, presented in October 1991 with a two week history of cognitive impairment noted by her husband. Eight years previously she had had Philadelphia positive chronic myeloid leukaemia diagnosed while she was pregnant. After delivery she was treated with hydroxyurea and busulphan, and in May 1991 she received bone marrow from a volunteer unrelated donor after conditioning with cyclophosphamide and total body irradiation. Her prophylaxis against graft versus host disease comprised T cell antibodies (Campath 1G), cyclosporin A, and methotrexate. The transplant was complicated by grade II graft versus host disease of the skin and upper gastrointestinal tract and candidiasis, which responded to high dose steroids and fluconazole.