Severe Brain Atrophy after Allogeneic Hematopoietic Stem Cell Transplantation in a Patient Suffering from Chronic Graft-versus-host Disease.

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.