Patient 1 47-year old female | Patient 2 39-year old female | |
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Primary tumor | 9.4 cm right paraspinal mass | 8 cm left thigh mass |
Prior chemotherapy | • Ifosfamide ×4 cycles • Doxorubicin ×6 cycles • Treatment break/surveillance • Pazopanib | • Doxorubicin/ifosfamide × 4 cycles • Pazopanib |
Sites of disease prior to lymphodepletion | • Bilateral lungs, spine, right groin | • Lung, local thigh recurrence |
Lymphodepletion regimen | • Fludarabine 20 mg/m2 (dose reduced from 30 mg/m2 due to renal dysfunction per protocol) daily ×4 days • Cyclophosphamide 1800 mg/m2 daily × 2 days | • Fludarabine 30 mg/m2 daily × 4 days • Cyclophosphamide 1800 mg/m2 daily × 2 days |
Onset of Symptoms of GBS/AIDP | • Day 42: 1-week history of numbness, paresthesia, heaviness to both legs; difficulty walking on day 42; pt. declined admission | • Month 4 follow-up visit: bilateral foot numbness, left foot drop, unsteady gait, and pain in left thigh |
Admission for workup of symptoms | • Day 46: admitted for workup; numbness & paresthesias w/hypoesthesia starting with feet & ascending to hips bilaterally | • Day 128: admitted for workup; additional worsening neurologic symptoms of peripheral sensory and motor neuropathy |
Electromyography / nerve conduction studies | • Day 48: very mild, distal motor, axonal polyneuropathy | • Non-length dependent demyelinating sensorimotor polyneuropathy |
Lumbar Puncture | • Day 49: CSF with no pleiocytosis, malignant cells, infectious processes, or albuminocytologic dissociation | • CSF with no malignant cells, low cell count, no bacteria, negative viral studies |
Intravenous Immuneglobulin (IVIG) | • Day 48–52: IVIG 0.4 g/kg/day for 5 days | • IVIG 0.4 g/m/day for 5 days |
Improvement of Symptoms | • Day 50: improvement in symptoms & strength per patient | • Improved strength the day after completion of IVIG |
Able to Ambulate | • Day 60: with walker under supervision | • 6-month follow-up visit: strength and sensory neuropathy continued to improve, but still using walker |