Full text
3/2026
vol. 35
Case report
Irreversible paraplegia due to transverse myelitis as a rare complication of CAR T-cell therapy in a patient with B-cell lymphoma
Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
Department of Neurology, Poznan University of Medical Science, Poznan, Poland
Department of Neurology, Poznan University Hospital, Poznan, Poland
Department of Hematology and Bone Marrow Transplantation, Poznan University Hospital, Poznan, Poland
Adv Psychiatry Neurol 2026; 35 (3): 218-223
Data publikacji online: 2026/09/29
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