title: Meningeal hematopoiesis following radiation myelitis in a hematopoietic stem-cell transplant recipient.
abstract: Extramedullary meningeal hematopoiesis (EMH) represents an uncommon finding after stem-cell transplantation. We describe the case of an allogeneic bone marrow transplantation (BMT) recipient who developed EMH 1 month after radiation myelitis had been diagnosed. A 39-year-old man with multiple myeloma underwent matched unrelated BMT following a myeloablative conditioning regimen of cyclophosphamide and total-body irradiation (200 cGyx6). This was followed by delivery of 40 Gy of involved-field radiation to an extramedullary plasmacytoma compressing the spinal cord. Although transplantation went extremely well, the patient developed radiation myelitis 7 months after transplantation, and EMH ensued 1 month later. Because the patient was not in a disease state known to cause EMH, it is tempting to speculate that radiation-related neural injuries might cause donor cells to migrate to the central nervous system.
authors.affiliation: Hematology Division, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Sakai
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hideki
authors.initials: H
authors.lastname: Akiyama
authors.forename: Tetuo
authors.initials: T
authors.lastname: Nemoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Kishida
authors.forename: Noriko
authors.initials: N
authors.lastname: Kamata
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D006411:Hematopoiesis, Extramedullary / Q000528:radiation effects*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008578:Meninges / Q000502:physiology; D009101:Multiple Myeloma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D009187:Myelitis / Q000134:cerebrospinal fluid / Q000209:etiology*; D011832:Radiation Injuries / Q000134:cerebrospinal fluid / Q000209:etiology*; D013116:Spinal Cord / Q000528:radiation effects*; D014916:Whole-Body Irradiation / Q000009:adverse effects