ARTICLE
31 December 2025
Nurse-Led Case Management for Wernicke’s Encephalopathy in Acute Myelomonocytic Leukemia Post Allogeneic Stem Cell Transplantation
Guangyan Fan Wenjie Wang Qiong Zhang
Show Less
1 School of Nursing, Hubei University of Medicine, Shiyan 442000, Hubei, China; Department of Hematology, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China,
2 Department of Nursing, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China,
3 Department of Hematology, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China,
JCNR 2025 , 9(12), 203–208; https://doi.org/10.26689/jcnr.v9i12.13307
© 2025 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Wernicke’s encephalopathy (WE), a neurological emergency caused by thiamine deficiency, represents a rare but life-threatening complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study details the nurse-led management of a 50-year-old man with acute myelomonocytic leukemia with eosinophilia (AML-M4Eo) who developed WE post-transplant. A structured nursing protocol was implemented, comprising comprehensive neurological monitoring (including consciousness and cranial nerve assessments), high-dose intravenous thiamine supplementation, individualized combined enteral and parenteral nutrition with gradual transition to oral intake, infection and bleeding prophylaxis, and psychological support using validated screening tools. After 27 days of integrated care, the patient achieved complete neurological recovery (Glasgow Coma Scale improved from 10 to 15), normalized thiamine levels (22.9 ng/mL), significant nutritional improvement, and fusion gene clearance. At the three-month follow-up, he maintained relapse-free status with substantially enhanced quality of life. This case emphasizes the vital role of systematic, nurse-driven interventions, incorporating early detection, targeted nutrient repletion, stepped nutritional rehabilitation, and psychosocial support, in optimizing WE outcomes post-allo-HSCT, supporting the integration of such multidimensional care into standard transplant protocols.

References
Leukemia & Lymphoma Group, Chinese Society of Hematology, Chinese Medical Association, 2023, Chinese Guidelines for Diagnosis and Treatment of Adult Acute Myeloid Leukemia. Chin J Hematol, 44(09): 705–712.
Dulamea A, Lupescu I, 2018, Neurological Complications of Hematopoietic Cell Transplantation in Children and Adults. Neural Regeneration Research, 13(6): 945–954.
Galvin R, Bråthen G, Ivashynka A, et al., 2010, EFNS Guidelines for Diagnosis, Therapy and Prevention of Wernicke Encephalopathy. European Journal of Neurology, 17(12): 239–252.
Cantu-Weinstein A, Branning R, Alamir M, et al., 2024, Diagnosis and Treatment of Wernicke’s Encephalopathy: A Systematic Literature Review. Gen Hosp Psychiat, 87: 48–59.
Arends J, Bachmann P, Baracos V, et al., 2017, ESPEN Guidelines on Nutrition in Cancer Patients. Clin Nutr, 36(1): 11–48.
Kang J, Yu K, Nutrition Oncology Branch of Chinese Nutrition Society, 2024, Consensus of Oral Nutritional Supplements for Patients with Cancer. Chin J Clin Nutr, 32(05): 279–288.
Kroenke K, Spitzer R, Williams J, 2001, The PHQ-9: Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine, 16(9): 606–613.
Guo H, Ning L, Feng Y, et al., 2023, Effects of Mindfulness Decompression Combined with Muscle Relaxation Training on Mental State and Sleep Quality in Young Patients with Depression. J Int Psychiatry, 50(04): 857–859 + 871.
Yuan Z, Zhang Y, 2023, Expert Consensus on Blood Transfusion of Allogeneic Hematopoietic Stem Cell Transplantation. Clin Transfus Lab Med, 25(05): 586–593.
Song Y, Zhu M, Lu Y, et al., 2021, Research on the Changing Trajectory and Influencing Factors of Quality of Life in Patients with Allogeneic Hematopoietic Stem Cell Transplantation. Chin J Nurs, 56(6): 867–872.
Stem Cell Application Group, Chinese Society of Hematology, Chinese Medical Association, 2023, Chinese Expert Consensus on the Management of Long-Term Complications After Hematopoietic Stem Cell Transplantation. Chin J Hematol, 44(09): 717–722.
Share
Back to top