1. ¹Center for Cell and Gene Therapy, Baylor College of Medicine and Methodist Hospital, Houston, TX, USA
2. ²Department of Pathology, Methodist Hospital, Weill Medical College of Cornell University, Houston, TX, USA

Correspondence: Dr RT Kamble, Center for Cell and Gene Therapy, Baylor College of Medicine, 6565 Fannin Street M-970, Houston, TX 77030, USA. E-mail: kamble@sbcglobal.net

Received 27 July 2006; Revised 18 September 2006; Accepted 15 October 2006; Published online 13 November 2006.

Abstract

Two patients with a plausible diagnosis of central nervous system graft-versus-host disease (CNS-GVHD) are described. Both presented with neurological manifestations 6 and 18 months following allogeneic transplant with hemiparesis, seizure, encephalopathy and magnetic resonance findings of hyperintense white matter lesions on T-2 weighed images. Brain biopsy in one and autopsy in the other revealed profound perivascular lymphocytic infiltrates composed predominantly of T-lymphocytes that were of donor origin. Although an unequivocal diagnosis of CNS-GVHD is difficult to establish, the transplantation community should be aware of this controversial entity.