Central nervous system graft‐versus‐host disease post allogeneic stem cell transplant

Abstract

analysis with all tests being two-sided and significance taken for values P < 0AE05.The JAK2 mutation was identified in 48% of our ET population, which is a similar frequency to those reported by others. There was no difference in age at diagnosis, gender or disease duration between those with and those without the mutation. The proportion of patients receiving some form of cytoreductive therapy was also similar in both the groups. However, we found a significantly higher haemoglobin concentration at diagnosis in ET patients with the mutation (median 14AE2 ± 1AE5 g/dl vs. 13 ± 1AE7 g/dl, P ¼ 0AE0426) although no differences were seen in the packed cell volume, white cell or platelet counts. Thrombotic complications were more common in patients with the JAK2 mutation; 18 (62%) vs. 8 (26%), P ¼ 0AE009. Although arterial events were more common, overall there was no statistical difference between the two groups, as defined by JAK2 mutational status, for either the type or timing of the thrombotic event.Our data therefore suggests that the presence of the JAK2 mutation in ET defines a subgroup of patients with both a polycythaemic and thrombotic tendency, confirming the results of recent studies. The ease of screening for the V617F mutation makes it a very attractive tool for diagnostic purposes but its role in risk stratification for therapy remains to be further evaluated.

Central nervous system graft-versus-host disease: report of two cases and literature review

“…Involvement of other organ systems is described; however, confounding factors including infections, drugs and autoimmune manifestations can make diagnosis challenging. Of the 10 patients with possible central nervous system (CNS)-GVHD described in the English literature, [2][3][4][5][6][7][8][9][10] histologic interpretation is available in only five cases; 2,3,5,8 and ante-mortem histologic diagnosis was established in only one. 8 In this report we describe two cases of possible CNS-GVHD where the diagnosis was accompanied by extensive immunophenotype and chimeric studies.…”

Chronic Graft-versus-host Disease Presenting with Multiple Punctate Intracranial Lesions on Contrast-enhanced Magnetic Resonance Imaging

“…The neurological symptoms were diverse, and included motor paralysis, ataxia, and convulsions. Some patients presented with only psychiatric symptoms and cognitive dysfunction (9,11,12,14), whereas others presented with optic neuritis and myelitis, similar to the optic neuritis and myelitis induced by multiple sclerosis (8,13). …”

Encephalomyelitis Mimicking Multiple Sclerosis Associated with Chronic Graft-Versus-Host Disease after Allogeneic Bone Marrow Transplantation

“…Although GVHD commonly affects the skin, gastrointestinal tract, liver, and hematopoietic system, recent reports have described patients with neurologic manifestations associated with GVHD (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Animal studies support the possibility of the brain being a target organ for GVHD (15) …”