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Results were then contrasted depending on whether pCNS-GvHD onset occurred before or after Day 100 following allogeneic haematopoietic stem cell transplantation (allo-HSCT).The median time between allo-HSCT and pCNS-GvHD onset was 149 days (interquartile range25–75 48–321), and pCNS-GvHD onset occurred before Day 100 following transplantation in 44% of patients. The most frequent findings at presentation were cognitive impairment (41%), paresis (21%), a Keywords: GvHD; neurological complications; encephalitis; brain lesions; spinal cord lesions; immune-mediated Author: Nicolas Lambert Creator: Servigistics Arbortext Advanced Print Publisher 11.1.4546/W-x64 Producer: PDFlib+PDI 9.0.7p3 (C++/Win64); modified using iTextSharp.LGPLv2.Core 3.7.4.0 CreationDate: Tue Apr 1 20:24:57 2025 CEST ModDate: Tue Nov 18 08:32:30 2025 CET Custom Metadata: yes Metadata Stream: yes Tagged: yes UserProperties: no Suspects: no Form: AcroForm JavaScript: no Pages: 12 Encrypted: no Page size: 612.283 x 790.866 pts Page rot: 0 File size: 729552 bytes Optimized: no PDF version: 1.6 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- BOTZRG+TimesNewRomanPSMT CID TrueType Identity-H yes yes yes 39 0 HAXQAL+CaeciliaLTStd-Roman Type 1C Custom yes yes yes 34 0 HNYQGH+CaeciliaLTStd-Bold Type 1C Custom yes yes yes 33 0 BLZCRK+CaeciliaLTStd-Italic Type 1C Custom yes yes yes 41 0 BRCGKO+STIXGeneral-Regular Type 1C Custom yes yes yes 40 0 TOPEBD+ArialMT TrueType WinAnsi yes yes no 1 0 SGRHWB+CaeciliaLTStd-Heavy Type 1C Custom yes yes yes 35 0 EDBHRO+STIXGeneral-Bold Type 1C Custom yes yes yes 50 0 STXPVG+CaeciliaLTStd-BoldItalic Type 1C Custom yes yes yes 54 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-11-19 04:10:06 CET RepresentationInformation: 321766.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-11-18 08:32:49 CET Size: 729552 Format: PDF Version: 1.6 Status: Well-Formed, but not valid SignatureMatches: PDF-hul ErrorMessage: Invalid indirect destination - referenced object 'affrefawae340-aff25' cannot be found ID: PDF-HUL-149 ErrorMessage: edu.harvard.hul.ois.jhove.module.pdf.PdfInvalidException: Invalid indirect destination - referenced object 'affrefawae340-aff25' cannot be found ID: PDF-HUL-122 Offset: 556471 MIMEtype: application/pdf Profile: Tagged PDF PDFMetadata: Objects: 1551 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: false CenterWindow: false DisplayDocTitle: true NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: OneColumn PageMode: UseOutlines Language: en Outlines: Item: Title: Introduction Destination: secawae340-s1 Item: Title: Materials and methods Destination: secawae340-s2 Children: Item: Title: Study design and participants Destination: secawae340-s2.1 Item: Title: Procedures Destination: secawae340-s2.2 Item: Title: Objectives Destination: secawae340-s2.3 Item: Title: Statistical analyses Destination: secawae340-s2.4 Item: Title: Results Destination: secawae340-s3 Children: Item: Title: Patients Destination: secawae340-s3.1 Item: Title: Clinical characteristics of possible CNS-graft-versus-host disease Destination: secawae340-s3.2 Item: Title: Radiological characteristics Destination: secawae340-s3.3 Item: Title: CSF characteristics Destination: secawae340-s3.4 Item: Title: Histopathological analyses Destination: secawae340-s3.5 Item: Title: Treatment Destination: secawae340-s3.6 Item: Title: Outcome Destination: secawae340-s3.7 Item: Title: 2010 criteria for chronic CNS-GvHD Destination: secawae340-s3.8 Item: Title: Syndromic approach Destination: secawae340-s3.9 Item: Title: Discussion Destination: secawae340-s4 Item: Title: Data availability Destination: secawae340-s5 Item: Title: Acknowledgements Destination: acknow Item: Title: Funding Destination: secawae340-s6 Item: Title: Competing interests Destination: secawae340-s7 Item: Title: Supplementary material Destination: secawae340-s8 Item: Title: Appendix 1 Destination: apnd Item: Title: References Destination: reflist Info: Title: CNS manifestations in acute and chronic graft-versus-host disease Author: Nicolas Lambert Subject: DOI: 10.1093/brain/awae340; Brain, 148, 4, 2024-10-23.; Abstract: Despite the growing evidence supporting the existence of CNS involvement in acute and chronic graft-versus-host disease (CNS-GvHD), the characteristics and course of the disease are still largely unknown. In this multicentre retrospective study, we analysed the clinical, biological, radiological and histopathological characteristics, as well as the clinical course of 66 patients diagnosed with possible CNS-GvHD (pCNS-GvHD), selected by predetermined diagnostic criteria. Results were then contrasted depending on whether pCNS-GvHD onset occurred before or after Day 100 following allogeneic haematopoietic stem cell transplantation (allo-HSCT).The median time between allo-HSCT and pCNS-GvHD onset was 149 days (interquartile range25 75 48 321), and pCNS-GvHD onset occurred before Day 100 following transplantation in 44% of patients. The most frequent findings at presentation were cognitive impairment (41%), paresis (21%), a Keywords: GvHD; neurological complications; encephalitis; brain lesions; spinal cord lesions; immune-mediated Creator: Servigistics Arbortext Advanced Print Publisher 11.1.4546/W-x64 Producer: PDFlib+PDI 9.0.7p3 (C++/Win64); modified using iTextSharp.LGPLv2.Core 3.7.4.0 CreationDate: Tue Apr 01 20:54:57 CEST 2025 ModDate: Tue Nov 18 08:32:30 CET 2025 ID: 0xf790611bb861dfd7e953e353a7af0a44, 0x4911b4640f9384e00c0d42865c9ccd72 Filters: FilterPipeline: FlateDecode FilterPipeline: DCTDecode Images: Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 2236 ImageHeight: 254 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 900 ImageHeight: 630 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1005 ImageHeight: 833 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 854 ImageHeight: 1721 BitsPerSample: 8 BitsPerSampleUnit: integer Fonts: Type0: Font: BaseFont: BOTZRG+TimesNewRomanPSMT Encoding: Identity-H ToUnicode: true Type1: Font: BaseFont: HNYQGH+CaeciliaLTStd-Bold FontSubset: true FirstChar: 1 LastChar: 74 FontDescriptor: FontName: HNYQGH+CaeciliaLTStd-Bold Flags: Nonsymbolic, ForceBold FontBBox: -166, -273, 1141, 938 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: HAXQAL+CaeciliaLTStd-Roman FontSubset: true FirstChar: 1 LastChar: 89 FontDescriptor: FontName: HAXQAL+CaeciliaLTStd-Roman Flags: Nonsymbolic FontBBox: -167, -270, 1136, 926 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: EDBHRO+STIXGeneral-Bold FontSubset: true FirstChar: 1 LastChar: 3 FontDescriptor: FontName: EDBHRO+STIXGeneral-Bold Flags: Nonsymbolic, ForceBold FontBBox: -1030, -455, 2000, 1055 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: SGRHWB+CaeciliaLTStd-Heavy FontSubset: true FirstChar: 1 LastChar: 33 FontDescriptor: FontName: SGRHWB+CaeciliaLTStd-Heavy Flags: Nonsymbolic, ForceBold FontBBox: -170, -277, 1146, 970 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: STXPVG+CaeciliaLTStd-BoldItalic FontSubset: true FirstChar: 1 LastChar: 2 FontDescriptor: FontName: STXPVG+CaeciliaLTStd-BoldItalic Flags: Nonsymbolic, Italic, ForceBold FontBBox: -169, -273, 1082, 932 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: BRCGKO+STIXGeneral-Regular FontSubset: true FirstChar: 1 LastChar: 5 FontDescriptor: FontName: BRCGKO+STIXGeneral-Regular Flags: Nonsymbolic FontBBox: -995, -455, 2000, 1055 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: BLZCRK+CaeciliaLTStd-Italic FontSubset: true FirstChar: 1 LastChar: 44 FontDescriptor: FontName: BLZCRK+CaeciliaLTStd-Italic Flags: Nonsymbolic, Italic FontBBox: -166, -270, 1053, 915 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true TrueType: Font: BaseFont: TOPEBD+ArialMT FontSubset: true FirstChar: 32 LastChar: 121 FontDescriptor: FontName: TOPEBD+ArialMT Flags: Nonsymbolic FontBBox: -664, -324, 2000, 1039 FontFile2: true Encoding: WinAnsiEncoding CIDFontType2: Font: BaseFont: BOTZRG+TimesNewRomanPSMT CIDSystemInfo: Registry: Adobe Registry: Identity Supplement: 0 FontDescriptor: FontName: BOTZRG+TimesNewRomanPSMT Flags: Nonsymbolic FontBBox: -568, -307, 2046, 1040 FontFile2: true XMP: uuid:ca2d91fc-d2f0-46e2-b757-c724c8ea0183 uuid:902913C4-0613-CC43-E13B-3A960CDDC51A True GvHD; neurological complications; encephalitis; brain lesions; spinal cord lesions; immune-mediated PDFlib+PDI 9.0.7p3 (C++/Win64); modified using iTextSharp.LGPLv2.Core 3.7.4.0 application/pdf 10.1093/brain/awae340 en Oxford University Press CNS manifestations in acute and chronic graft-versus-host disease Nicolas Lambert Florence Forte Majdouline El Moussaoui Justine Monseur Nicole Raus Alexey Polushin David Michonneau Carl Shultz William J. Hogan Aitana Balaguer-Roselló Sara Gil-Perotín Jan Brijs Paul Chauvet Maria Gavriilaki Martin Carre Adriana Octaviana Dulamea Yves Chalandon Urpu Salmenniemi Andrea Duminuco Ron Ram Irene García-Cadenas Gaetana Porto Stéphanie Nguyen Portia Smallbone Marta González-Vicent Jonathan D. Santoro Evelyne Willems Frédéric Baron Sophie Servais Yves Beguin Pierre Maquet DOI: 10.1093/brain/awae340; Brain, 148, 4, 2024-10-23.; Abstract: Despite the growing evidence supporting the existence of CNS involvement in acute and chronic graft-versus-host disease (CNS-GvHD), the characteristics and course of the disease are still largely unknown. In this multicentre retrospective study, we analysed the clinical, biological, radiological and histopathological characteristics, as well as the clinical course of 66 patients diagnosed with possible CNS-GvHD (pCNS-GvHD), selected by predetermined diagnostic criteria. Results were then contrasted depending on whether pCNS-GvHD onset occurred before or after Day 100 following allogeneic haematopoietic stem cell transplantation (allo-HSCT).The median time between allo-HSCT and pCNS-GvHD onset was 149 days (interquartile range25–75 48–321), and pCNS-GvHD onset occurred before Day 100 following transplantation in 44% of patients. The most frequent findings at presentation were cognitive impairment (41%), paresis (21%), a © The Author(s) 2024. Published by Oxford University Press on behalf of the Guarantors of Brain. GvHD neurological complications encephalitis brain lesions spinal cord lesions immune-mediated Journal Brain © The Author(s) 2024. 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