{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T22:15:09Z","timestamp":1767824109303,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2008,1,29]],"date-time":"2008-01-29T00:00:00Z","timestamp":1201564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2008,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Isolated EMR in the CNS is a relatively rare form of recurrent leukemia. We report here a case of a 38\u2010year\u2010old man with inv(16) acute myeloid leukemia (AML, M2) who suffered a central nervous system (CNS) relapse after allogeneic bone marrow transplantation (BMT) from a human leukocyte antigen (HLA)\u2010matched sibling donor. After complete remission was achieved by chemotherapy, he received allogeneic BMT from his HLA\u2010matched sister. His leukemia relapsed in the CNS 2.5 years after the allogeneic BMT. Lumbar puncture revealed 780\/\u03bcL white blood cells with 67.3% leukemia cells and 32.7% mature lymphocytes. Fluorescent <jats:italic>in situ<\/jats:italic> hybridization (FISH) using a probe for the Y chromosome demonstrated that both leukemia cells and lymphocytes in the cerebrospinal fluid (CSF) were derived from the recipient, although the bone marrow cells were from the donor. No leukemia cells with inv(16) were detected by FISH in the bone marrow. This is the first report to clarify the chimerism of lymphocytes in the CSF of patients with isolated EMR in the CNS after allogeneic SCT, in which analysis revealed that autologous immunologic cells rather than donor lymphocytes responded to the recurrent isolated leukemic cells in CNS. This observation suggests that the CNS is a \u201csanctuary\u201d site not only from chemotherapy but also from the graft\u2010versus\u2010leukemia effect. The present case contributes to our understanding of the possibility of immunological escape phenomenon of recurrent leukemia cells in extramedullary sites. Am. J. Hematol., 2008. \u00a9 2008 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajh.21165","type":"journal-article","created":{"date-parts":[[2008,2,27]],"date-time":"2008-02-27T22:47:41Z","timestamp":1204152461000},"page":"512-514","source":"Crossref","is-referenced-by-count":2,"title":["Isolated extramedullary relapse presenting as autologous lymphocyte response"],"prefix":"10.1002","volume":"83","author":[{"given":"Osamu","family":"Imataki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Ohnishi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Kitanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshitsugu","family":"Kubota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terukazu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiko","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,2,27]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1995.13.7.1800"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1989.7.1.50"},{"key":"e_1_2_1_3_3","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1200\/JCO.1989.7.4.545","volume":"7","year":"1989","journal-title":"J Clin Oncol"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702488"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19940415)73:8<2107::AID-CNCR2820730815>3.0.CO;2-W"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19990201)85:3<608::AID-CNCR11>3.0.CO;2-5"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704223"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20421"},{"key":"e_1_2_1_9_2","first-page":"1380","article-title":"Anti\u2010leukemic effect of graft\u2010versus\u2010host disease on bone marrow and extramedullary relapses in acute leukemia","volume":"90","author":"Lee JH","year":"2005","journal-title":"Haematologica"},{"key":"e_1_2_1_10_2","first-page":"180","article-title":"Lack of a graft\u2010versus\u2010leukemia effect in an immunologically privileged sanctuary site","volume":"14","author":"Goldberg SL","year":"1994","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1701043"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703572"},{"key":"e_1_2_1_13_2","first-page":"801","article-title":"Acute and chronic leukemia working parties of the European group for blood and marrow transplantation. 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