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Central nervous system graft-versus-host disease presenting with granulomatous encephalitis

Bone Marrow Transplantation volume 40, pages 183–184 (2007)Cite this article

Kamble et al.1 recently reported two cases of central nervous system (CNS) graft-versus-host disease (GVHD) and performed a literature review. We report a patient with hemiparesis secondary to granulomatous encephalitis that was believed to be a manifestation of GVHD.

The patient is a 41-year-old male diagnosed with follicular lymphoma in 2003. He was initially treated with six cycles of fludarabine, mitoxantrone and rituximab and achieved a partial remission. At relapse in 2004, he received six cycles of CHOP (cyclophosphamide, adriamycin, vincristine and prednisone) with a partial remission. Because of the short duration of initial remission, he was referred for consideration of stem cell transplantation (SCT) and underwent a sibling allogeneic SCT from his HLA-matched sister in 2005. Conditioning chemotherapy was busulfan (1 mg/kg p.o. q.i.d. for 4 days) followed by cyclophosphamide (60 mg/kg i.v. for 2 days) and he received GVHD prophylaxis with short-course methotrexate (days 1, 3, 6 and 11) and cyclosporin.

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Authors and Affiliations

  1. Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada

    A K Kew & S Couban

  2. Department of Pathology and Laboratory Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada

    R Macaulay

  3. Department of Diagnostic Imaging, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada

    S Burrell

  4. Department of Medicine, The Moncton Hospital, Moncton, New Brunswick, Canada

    S Rubin & G Dow

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  1. A K Kew
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  2. R Macaulay
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  3. S Burrell
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  4. S Rubin
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  5. G Dow
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  6. S Couban
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Correspondence to A K Kew.

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Kew, A., Macaulay, R., Burrell, S. et al. Central nervous system graft-versus-host disease presenting with granulomatous encephalitis. Bone Marrow Transplant 40, 183–184 (2007). https://doi.org/10.1038/sj.bmt.1705709

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