Serendipitous Improvement of Schizophrenia After Triple Bone Marrow Stem Cell Transplant for Cancer: A Case Report
This poster was presented at the 30th annual Psych Congress, held Sept. 16-19, 2017, in New Orleans, Louisiana.
A 21-year-old male patient with schizophrenia diagnosed at 15 with a history of poor response to olanzapine and risperidone. He referred auditory hallucinations with a pejorative content about himself. He was very suspicious and socially withdrawn, to the extent of dropping out of high school and being unable to leave his home. One year afterwards he was diagnosed with Hodgkin's Lymphoma. He underwent different chemotherapeutic schemes and three bone marrow transplants (BMT). Between the second (autologous) and the third BMT (allogeneic) the patient received therapeutic doses of quetiapine (Positive and Negative Syndrome Scale [PANSS]: 147). In a period of 8 months, after the second BMT, patient's PANSS dropped 60 points, his hallucinations decreased 90%, and he improved his negative, cognitive and social symptoms, which allowed him to gradually reincorporate to his usual social and academic life. Hematopoietic stem cells (HSC) have been proposed as an alternative therapy for many chronic and incurable diseases. In psychiatry, the theory is that these HSC migrate to areas of inflammation in the brain via chemotaxis, and, through immunomodulation and secretion of bioactive molecules enhance neurogenesis, angiogenesis and remodeling of axonal circuits. Studies on schizophrenic patients have confirmed both, that it is an inflammatory condition (cytokines and interleukins are elevated when compared to controls) and, that the brain is underdeveloped due to deficient neurogenesis; supporting why HSC assisted in the dramatic clinical improvement observed in this patient, which would otherwise could not be explained by the natural history of the disease or therapeutic measures alone.