What question did this study set out to answer?

To investigate severe brain atrophy in a patient following allogeneic HSCT and chronic graft-versus-host disease.

February 5, 2026Open Access

Severe brain atrophy after allogeneic hematopoietic stem cell transplantation in a patient suffering from chronic graft-versus-host disease

YMYasutaka MasudaTokyo Metropolitan Komagome Hospital AHAkira HondaGunma University RYReo YoshiokaUniversity of Tokyo Hospital

Key Points

To investigate severe brain atrophy in a patient following allogeneic HSCT and chronic graft-versus-host disease.
Case report of a 30-year-old man with acute lymphoblastic leukemia
Assessment of neurological symptoms post-HSCT
Review of literature on CNS complications related to HSCT
Patient developed significant brain atrophy in bilateral medial temporal lobes one year post-transplant
Concurrent myositis noted, thought to be from chronic graft-versus-host disease
Neurological symptoms were resistant to steroid treatment and worsened with ibrutinib.

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with serious neurological sequelae in some patients. We herein present the case of a 30-year-old man who developed brain atrophy, especially in the bilateral medial temporal lobes approximately one year after undergoing HSCT for acute lymphoblastic leukemia. Together with myositis, which he concurrently experienced, and after ruling out other etiologies, the central nervous system (CNS) manifestations were considered to be chronic graft-versus-host disease. Both manifestations were refractory to steroid treatment and progressed when the patient was on ibrutinib. Previous reports on CNS complications of HSCT have been thoroughly reviewed, and the need for active surveillance and assessment of transplantation-related CNS alterations is also discussed.

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