scholarly journals Bone Marrow B cell Precursor Number after Allogeneic Stem Cell Transplantation and GVHD Development

2012 ◽  
Vol 18 (6) ◽  
pp. 968-973 ◽  
Author(s):  
Yuri Fedoriw ◽  
T. Danielle Samulski ◽  
Allison M. Deal ◽  
Cherie H. Dunphy ◽  
Andrew Sharf ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Cell Precursor

Frequency and Relevance of CD10+CD19+ Hematogones after Allogeneic Stem Cell Transplantation.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3280-3280
Author(s):  
Axel Nogai ◽  
Eckhard Thiel ◽  
Thomas Burmeister ◽  
Susanne Ganepola ◽  
Rita Lippoldt ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Cell Recovery ◽  
Whitney Test ◽  
Donor Chimerism ◽  
Mann Whitney Test

Abstract Hematogones are B-lymphocyte precursors found in large frequencies after chemotherapies. In this study, the frequency of CD10+CD19+ hematogones was analysed routinely prior and post allogeneic stem cell transplantation and compared with moelculargenetic data for donor chimerism and for clonal translocations. Because of similarities in morphology and immunophenotype with frequent expression of CD19, CD10 and TdT they may undistinguishable from malignant B-cell lymphoblasts. As one example underlying the diagnostic difficulties, one patient with thrombopenia day +60 after allogeneic stem cell transplantation is presented. A relapse of Richter’s syndrome was suspected. Investigations of bone marrow specimens revealed a mixed chimerism, the frequency of cells coexpressing CD10 and CD19 was 28%. However, a CD19-sorted chimerism revealed an almost complete donor chimerism. Donor-lymphocytes were administered to improve graft function. Afterwards, donor chimerism reached 100% and platelets reached normal values, but hematogones continued to exceed 5% in the following specimens. As a result of such cases, bone marrow specimens after allogeneic stem cell transplantation were systematically analyzed for the presence of hematogones. METHODS: Hematogones were analyzed by routine 2-color flow cytometry. Cells coexpressing CD10 and CD19 with lymphocytic light scatter properties were regarded as hematogones. Percentage of cells was determined on the basis on total events. 133 patients undergoing allogeneic stem cell transplantation for AML, ALL, CLL, MM, NHL or aplastic anemia from 2003 to 2008 and surviving more than 60 days after transplantation were included in the analysis. During follow-up, bone marrow specimens were collected 1, 2, 3 and 12 months and in patients with suspected relapse. In total, 446 bone marrow specimens prior (186 specimen) and after (260 specimen) transplantation were collected and reevaluated for the frequencies of hematogones. RESULTS: The frequency of hematogones exceeded 5% in 8 of 186 specimens prior but in 62 of 260 specimens after transplantation (4.3% and 23.8%, respectively; p<0.001 Chi-Square). During follow-up, the median frequency of hematogones of patients in remission increased from 0.21% prior transplantion to 1.9% at two months after transplantation (range 0% to 13% and 0% to 32.0%, respectively; p=0.001 Mann-Whitney test) with no significant decrease of hematogones 3 and 12 months after transplantation. In contrast, the frequency of hematogones was significantly decreased (median 0.17%; range 0% to 16.7%; p=0.02 Mann-Whitney-test compared to day+60) in patients with relapses other than ALL. Patients with more than 5% hematogones at any time after transplantation were significantly younger (median 41 vs. 54 years; p=0.01 Mann-Whitney test) and received more often myeloablative conditioning therapies (p=0.016 Chi-square) compared to patients with less 5% hematogones. In contrast, the relapse rate or the overall survival, the underlying disease, source of stem cells, immunoglobulin levels prior and one year after transplantation as well as the number of transfused stem cells were not correlated with the maximal frequencies of hematogones. DISCUSSION: In this study, varying patterns of early B-cell recovery after allogeneic stem cell transplantation were found. Presence of large numbers of hematogones may be misinterpreted as a relapse in patients with B-cell malignancies. Presence of cells coexpressing CD10 and CD19 should be regarded with caution and always be interpreted with moleculargenetic data. The physiological and clinical effects of early B-cell recovery after allogeneic stem cell transplantation remain to be investigated in more detail.

scholarly journals Measuring the cellular memory B cell response after vaccination in patients after allogeneic stem cell transplantation

2020 ◽  
Vol 99 (8) ◽  
pp. 1895-1906
Author(s):  
Julia Winkler ◽  
Hannes Tittlbach ◽  
Andrea Schneider ◽  
Corinna Buchstaller ◽  
Andreas Mayr ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Cell Response ◽  
Cellular Memory ◽  
Memory B Cell ◽  
B Cell Response

The Treatment of Delayed Rejection after Boosting of Mononuclear Cells of Her Mother and Chronic Graft Versus Host Disease in Leukemia Recipient Who Underwent Allogeneic Hyplo-Identical Transplantation in Second Remission with Therapeutic Plasma Exchange.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5237-5237
Author(s):  
Zhisheng Jiang ◽  
Da Li ◽  
Shunjie Wu ◽  
Kun Liu ◽  
Ying Kang ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
T Lymphocyte ◽  
Allogeneic Stem Cell Transplantation ◽  
Mononuclear Cells ◽  
Whole Body ◽  
Gene Map ◽  
Delayed Rejection

Abstract Patient is a Chinese girl of 13 years. She had fever, weakness, headache, and was hospitalized on Feb 20th, 2003. There were 0.89 leukemic monocytes in her bone marrow smear at diagnosis. She was diagnosed acute monoblastic leukemia (M5b) according to FAB classification. The immunophenotyping of bone marrow cells showed CD13 0.579, CD15 0.289, CD33 0.78, cMPO 0.27. After the second remission, she underwent hyplo-identical, ABO-matched combination transplantation of bone marrow and peripheral blood stem cells of her donor mother with T-cell deletion in Aug. 2005. Her hemapoiesis recovered at +10d after transplantation. The while complete blood cell count recovered at +31d when the TCR-PCR DNA gene map was showed the chimera. The rejection appeared at +60d. Her blood picture showed Hb 63g/L, Plt 1.0×109/L, WBC 0.4×109/L. The bone marrow picture showed hypo-cellular as same as in severe aplastic anemia. The TCR-PCR DNA gene map showed the 3/16 locus of recipient. The schedule of treatment of delayed rejection was the combination of Cyclosporin A (CsA), Mycophemolate Mofeil (MMF) and Methylprednisolone (MP). She boosted the G-CSF-primed peripheral mononuclear cells of her mother. The cell dose was 4.3×108/kg without T-deletion. Then she received the stimulation of G-CSF 250 ug daily. One week later, she suffered from Herpes Zoster Virus (HZV) infection. There was characteristic HZV varicella in full right side of head, right face, right eye, and right hand with high fever, malaise. She felt severe postherpetic neuralgia. Only morphine or remain acupuncture can relieve her severe neuralgia. She had also severe pancytopenia, gastrointestinal bleeding. We had to transfuse backed red cell and platelet concentration every week. She received first TPE at +130d and second TPE at +137d after transplantation. Dramatic results were gotten after the two TPE. After TPE she did not need transfusion again. After the third TPE, she was discharged then had treated small dose of CsA for half year. The STR-PCR DNA gene map showed the gene type from her mother. At +311d she suffered from chronic graft versus disease (cGVHD). The skin lesion involved her whole body skin about was about 50% body surface area. The effect had not received after treatment with TPE. The cGVHD had not controlled after the basic treatment with CsA or Sirolimus (FK506), MMF, MP, and Thalidomide 100–400 mg/d. So we added with ultraviolet-B irradiation (UV-B) therapy with dose of narrowbank UV-B, twice a week. The lichenification planum was disappearing. The mechanism of TPE on delayed rejection in ABO-unmatched, allogeneic stem cell transplantation has been clear. But, it is still not clear in ABO-matched and hyplo-identical allogeneic stem cell transplantation. It may be cause humoral rejection as same as ABO-incompatible stem cell or solid organ transplantation. The antibodies have resulted from hyplo-identical allogeneic stem cell of her mother. The mechanism of cGVHD results from donor T-lymphocyte activated and involves skin, liver, gut and so on. It is effective of treatment of cGVHD with immune inhibitor drugs but with TPE. Recently reported ECP is effective because the method result in suppressing the activated T-lymphocyte in recipient.

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