Acute acquired demyelinating polyneuropathy with respiratory failure following high-dose systemic cytosine arabinoside and marrow transplantation.

Reversible ventilatory failure secondary to acute, acquired polyneuropathy developed in a patient undergoing marrow transplantation for chronic myelogenous leukemia. The onset of the neuropathy was temporally related to the conditioning regimen of high-dose, systemic cytosine arabinoside (Ara-C). The clinical features and course were consistent with the Guillain-Barré syndrome and no other conditions causally associated with the syndrome were noted. Although central nervous system toxicity is a well recognized complication of high-dose Ara-C, peripheral neuropathy is infrequently reported. Possible mechanisms of peripheral polyneuropathy in this marrow transplant recipient are discussed.