{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:12:55Z","timestamp":1788786775947,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The National Natural Science Foundation of China","award":["81900186"],"award-info":[{"award-number":["81900186"]}]},{"name":"The National Natural Science Foundation of China","award":["82072212"],"award-info":[{"award-number":["82072212"]}]},{"DOI":"10.13039\/501100006606","name":"natural science foundation of tianjin city","doi-asserted-by":"publisher","award":["21JCQNJC00070"],"award-info":[{"award-number":["21JCQNJC00070"]}],"id":[{"id":"10.13039\/501100006606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015406","name":"tianjin municipal science and technology bureau","doi-asserted-by":"publisher","award":["19JCZDJC35400"],"award-info":[{"award-number":["19JCZDJC35400"]}],"id":[{"id":"10.13039\/501100015406","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cell Transplant"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>We present a differential diagnosis of an intracranial lesion following haploidentical stem cell transplantation (haplo-SCT) in a female patient with acute lymphoblastic leukemia (ALL). This patient received an anti-CD19-chimeric antigen receptor (CAR) T-cell therapy for refractory B-cell ALL and obtained minimal residual disease (MRD)-positive (0.03%) complete remission (CR). Then the patient received a bridging therapy of haplo-SCT. After bridging therapy, the patient maintained MRD-negative and full donor chimerism in bone marrow (BM) and was negative for Epstein\u2013Barr virus (EBV)-DNA copy in peripheral blood. At 91 days after haplo-SCT, the patient presented with dizziness and fatigue and magnetic resonance imaging (MRI) demonstrated an intracranial lesion. The diagnosis of isolated extramedullary relapse (IEMR) was temporarily considered. Then next-generation sequencing (NGS) identified positive EBV-DNA in the cerebrospinal fluid, although EBV-DNA in the peripheral blood was negative. Furthermore, the positive EBV-DNA by NGS and complete donor chimerism in the brain tissue confirmed the diagnosis of central nervous system post-transplant lymphoproliferative disorder (CNS-PTLD). However, the EBV-encoded small RNAs (EBERs) in situ hybridization was sparsely positive. The patient was subsequently treated with anti-CD22-CAR T cells in combination with Zanubrutinib, but the disease progressed quickly and died. Donor chimerism examination of focal biopsy provides important evidence for diagnosing PTLD. Furthermore, NGS detection of EBV-DNA in local lesions is more valuable for diagnosing PTLD than detection of EBV-DNA in the peripheral blood.<\/jats:p>\n                  <jats:p>Trial registration: The patient was enrolled in a clinical trial of ChiCTR1800019622 and ChiCTR1800019298.<\/jats:p>","DOI":"10.1177\/09636897221117532","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T06:08:13Z","timestamp":1660802893000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Case of Central Nervous System Post-Transplant Lymphoproliferative Disorder Following Haploidentical Stem Cell Transplantation in a Patient With Acute Lymphoblastic Leukemia"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0515-9833","authenticated-orcid":false,"given":"Haibo","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Hematology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuequan","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"key":"bibr1-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1701319"},{"key":"bibr2-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1080\/10428190600632857"},{"key":"bibr3-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1080\/10428190600967022"},{"key":"bibr4-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702659"},{"key":"bibr5-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.6.2052"},{"key":"bibr6-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-07-143545"},{"key":"bibr7-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.4.972"},{"key":"bibr8-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-05-615872"},{"key":"bibr9-09636897221117532","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2019.02.016"},{"key":"bibr10-09636897221117532","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.087338"},{"issue":"6","key":"bibr11-09636897221117532","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1093\/cid\/cit391","volume":"57","author":"Styczynski 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