Acute autoimmune hemolytic anemia following unrelated cord blood transplantation as an early manifestation of chronic graft-versus-host disease.

Abstract:

:A 16-month-old girl diagnosed with osteopetrosis underwent an unrelated, partially matched (with major mismatch at A locus) cord blood stem cell transplant. Twelve months later she developed severe acute autoimmune hemolytic anemia (AIHA). Immunophenotype analysis of lymphocyte subsets 8 months post transplant showed a low number of T lymphocytes, with normal subsets, and with NK cells and B lymphocytes within normal ranges. When the hemolytic anemia developed, the lymphocytes subsets changed and analysis showed higher numbers of B lymphocytes than previously, lower CD3+ T lymphocytes with inversion of the CD4/CD8 ratio and an abnormal proportion of T lymphocyte subsets. She was being treated with cyclosporine, and steroids and immunoglobulins were added. Initially the AIHA improved, but repeated infectious episodes led us to tail off the immunosuppressive treatment. The AIHA relapsed and cyclosporine was restarted. Currently, she is on cyclosporine and low-dose steroid treatment with no hemolytic features. During the 3 months when the AIHA was being treated, she developed extensive skin cGVHD and recurrent pneumothoraces. AIHA may be the first manifestation of abnormal reconstitution of immunity developing after a hematopoietic transplant. This abnormal reconstitution is also the basis of cGVHD. We suggest that aggressive immunosuppressive treatment with intensive measures against infection could give a better prognosis to such patients.

journal_name

Bone Marrow Transplant

authors

Sevilla J,González-Vicent M,Madero L,Díaz MA

doi

10.1038/sj.bmt.1703087

subject

Has Abstract

pub_date

2001-07-01 00:00:00

pages

89-92

issue

1

eissn

0268-3369

issn

1476-5365

journal_volume

28

pub_type

杂志文章
  • Multiple myeloma: the number of reinfused plasma cells does not influence outcome of patients treated with intensified chemotherapy and PBPC support.

    abstract::Multiple myeloma (MM) is characterized by the expansion of tumor plasma cells in bone marrow (BM), but neoplastic cells have been consistently detected in peripheral blood (PB). Peripheral blood progenitor cell (PBPC) collections have been widely used to support high-dose therapy for MM patients. A flow cytometric tec...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1702085

    authors: Boccadoro M,Omedé P,Dominietto A,Palumbo A,Bringhen S,Giaretta F,Ortolano B,Triolo S,Pileri A

    更新日期:2000-01-01 00:00:00

  • Towards a global system of vigilance and surveillance in unrelated donors of haematopoietic progenitor cells for transplantation.

    abstract::Safety of living donors is critical to the success of blood, tissue and organ transplantation. Structured and robust vigilance and surveillance systems exist as part of some national entities, but historically no global systems are in place to ensure conformity, harmonisation and the recognition of rare adverse events...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2013.104

    authors: Shaw BE,Chapman J,Fechter M,Foeken L,Greinix H,Hwang W,Phillips-Johnson L,Korhonen M,Lindberg B,Navarro WH,Szer J

    更新日期:2013-11-01 00:00:00

  • New frontiers in pediatric Allo-SCT: novel approaches for children and adolescents with ALL.

    abstract::Although most children with ALL can be cured by chemotherapy approaches, allogeneic hematopoietic cell transplant (HCT) therapy offers a better chance of cure to selected high-risk patients in first remission and most children who relapse. Although transplant-related mortality has decreased significantly in the past d...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,评审

    doi:10.1038/bmt.2014.114

    authors: Pulsipher MA,Wayne AS,Schultz KR

    更新日期:2014-10-01 00:00:00

  • GM-CSF-mobilized peripheral blood CD34+ cells differ from steady-state bone marrow CD34+ cells in adhesion molecule expression.

    abstract::To determine the effect of growth factor mobilization on the expression of adhesion molecules, we compared CD34+ progenitor cell (PC) populations from steady-state bone marrow (BM) with granulocyte-macrophage colony-stimulating factor (GM-CSF)-mobilized apheresis products (peripheral blood stem cell (PSC)) using flow ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1700814

    authors: Watanabe T,Dave B,Heimann DG,Lethaby E,Kessinger A,Talmadge JE

    更新日期:1997-06-01 00:00:00

  • Alternative donor SCT for the treatment of MHC class II deficiency.

    abstract::MHC Class II deficiency is a rare primary immunodeficiency disease characterized by absent HLA Class II expression resulting in CD4 lymphopenia, lack of Ag-specific responses and recurrent infection. Without successful allogeneic SCT, most children succumb to infection within the first decade of life. To date, alterna...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2012.140

    authors: Small TN,Qasim W,Friedrich W,Chiesa R,Bleesing JJ,Scurlock A,Veys P,Sparber-Sauer M

    更新日期:2013-02-01 00:00:00

  • Cytotoxic T-lymphocyte antigen 4 haplotype correlates with relapse and survival after allogeneic hematopoietic SCT.

    abstract::CTLA-4 is a negative regulator of activated T cells and the association of CTLA-4 polymorphisms with autoimmune diseases and transplant outcome has been reported. We evaluated the effect of donor CTLA-4 polymorphisms on outcome after allogeneic hematopoietic SCT (HSCT). We analyzed 147 Japanese HLA-matched sibling rec...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2010.319

    authors: Murase M,Nishida T,Onizuka M,Inamoto Y,Sugimoto K,Imahashi N,Murata M,Miyamura K,Kodera Y,Inoko H,Naoe T

    更新日期:2011-11-01 00:00:00

  • Mismatched bone marrow transplantation for Omenn syndrome: a variant of severe combined immunodeficiency.

    abstract::Omenn syndrome is a variant of SCID, inherited as an autosomal recessive disorder, and characterized by severe eczematoid dermatitis, eosinophilia, elevated serum IgE and a distinctive histology in enlarged lymph nodes. The etiology of Omenn syndrome is unknown, however, unlike other forms of SCID; patients with Omenn...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Loechelt BJ,Shapiro RS,Jyonouchi H,Filipovich AH

    更新日期:1995-09-01 00:00:00

  • Feasibility and timing of unrelated donor identification for patients with ALL.

    abstract::Patients with relapsed ALL frequently have short duration second or later remissions, leaving only a brief window of time when it is possible to perform BMT. When no sibling donor is available, identifying and unrelated donor in a timely fashion can be difficult while autologous BMT (ABMT) can be performed more quickl...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Davies SM,Ramsay NK,Weisdorf DJ

    更新日期:1996-05-01 00:00:00

  • Effects of incubation temperature and time after thawing on viability assessment of peripheral hematopoietic progenitor cells cryopreserved for transplantation.

    abstract::Three widely used viability assessments were compared: (1) membrane integrity of nucleated cells using trypan blue (TB) exclusion and a fluorometric membrane integrity assay (SYTO 13 and propidium iodide), (2) enumeration of viable CD34+ cells, and (3) clonogenic assay (granulocyte-macrophage colony-forming units, CFU...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1704247

    authors: Yang H,Acker JP,Cabuhat M,McGann LE

    更新日期:2003-11-01 00:00:00

  • Expression of TNFalpha by CD3+ and F4/80+ cells following irradiation preconditioning and allogeneic spleen cell transplantation.

    abstract::The pathogenesis of acute graft-versus-host disease (aGVHD) includes tumor necrosis factor-alpha (TNFalpha) expression by macrophages and T cells. However, the temporal comparison of donor vs host cells to TNFalpha expression in response to irradiation conditioning and alloreactivity has not been reported. This study ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1704362

    authors: Brown S,Konopa J,Zhou D,Thompson J

    更新日期:2004-02-01 00:00:00

  • Sensitivity of secondary acute myeloid leukemia relapsing after allogeneic bone marrow transplantation to immunotherapy with interferon-alpha 2b.

    abstract::A patient with acute myeloid leukemia secondary to therapy of choriocarcinoma underwent T cell non-depleted allogeneic bone marrow transplantation from an unrelated donor in first untreated relapse. Persistent/relapsed leukemia 4 months after transplantation did not respond to cessation of cyclosporine. Due to logisti...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1700793

    authors: Singhal S,Powles R,Treleaven J,Mehta J

    更新日期:1997-06-01 00:00:00

  • Autologous bone marrow transplantation for advanced stage adult lymphoblastic lymphoma in first complete remission. A pilot study of the non-Hodgkin's Lymphoma Co-operative Study Group (NHLCSG).

    abstract::Twenty successive adult patients with lymphoblastic lymphoma entered a study of sequential chemotherapy consisting of an intensive LSA2-L2-type protocol to induce first complete remission. Twelve patients in first CR (median age 22 years, range 15-43), after receiving a conditioning regimen consisting of cyclophospham...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Santini G,Coser P,Chisesi T,Porcellini A,Sertoli R,Contu A,Congiu AM,Manna A,Rossi E,Scarpati D

    更新日期:1989-07-01 00:00:00

  • A randomized trial of amifostine as a cytoprotectant for patients receiving myeloablative therapy for allogeneic hematopoietic stem cell transplantation.

    abstract::We initiated a randomized study of amifostine (the organic thiophosphate formerly known as WR-2721) given to patients during myeloablative conditioning therapy for allogeneic bone marrow transplantation. Amifostine was given at a dose of 1000 mg/day of conditioning and was well tolerated if attention was given to seru...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1038/sj.bmt.1704521

    authors: Hwang WY,Koh LP,Ng HJ,Tan PH,Chuah CT,Fook SC,Chow H,Tan KW,Wong C,Tan CH,Goh YT

    更新日期:2004-07-01 00:00:00

  • Impact of IKZF1 deletions on long-term outcomes of allo-SCT following imatinib-based chemotherapy in adult Philadelphia chromosome-positive ALL.

    abstract::We investigated the prognostic relevance of IKZF1 deletions in 118 adult Ph-positive ALL patients who had minimal residual disease (MRD) data under a uniform treatment of allo-SCT following first-line imatinib-based chemotherapy. IKZF1 deletions were identified in 93 patients (78.8%). IKZF1-deleted patients had a lowe...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2014.281

    authors: Kim M,Park J,Kim DW,Kim YJ,Jeon YW,Yoon JH,Shin SH,Yahng SA,Lee SE,Cho BS,Eom KS,Kim HJ,Min CK,Cho SG,Kim Y,Lee JW,Han K,Min WS,Lee S

    更新日期:2015-03-01 00:00:00

  • Functional aspects of cord blood lymphocytes response to polyclonal and allogeneic activation.

    abstract::With the purpose of contributing to a better knowledge of the phenotypic characteristics and functional activity of umbilical cord blood (UCB) lymphocytes, we have carried out extensive immunophenotyping of these cells, evaluated their immune response to polyclonal and allogeneic activation and then compared these res...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Paiva A,Freitas A,Loureiro A,Couceiro A,Martinho A,Simões O,Santos P,Tomaz J,Pais ML,Brêda Coimbra H

    更新日期:1998-07-01 00:00:00

  • The clinical value of biomarkers in respiratory complications in hematopoietic SCT.

    abstract::To determine the role of biomarkers in the clinical management of respiratory complications (RC) in hematopoietic stem cell transplantation (HSCT) recipients, we have prospectively evaluated a cohort of 175 patients followed-up for 1 year after HSCT. To avoid misinterpretation, we have excluded both unidentified respi...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1038/bmt.2016.280

    authors: Lucena CM,Rovira M,Gabarrús A,Filella X,Martínez C,Domingo R,Torres A,Agustí C

    更新日期:2017-03-01 00:00:00

  • Cyclosporine short infusion and C2 monitoring in haematopoietic stem cell transplant recipients.

    abstract::Blood concentrations of cyclosporine A (CsA) >or=800 microg/l measured 2 h post-dosing, the C2 concentration, is necessary to obtain a maximal pharmacological effect and correlates well with transplant-related complications such as transplant rejection and toxicity. In an open crossover study CsA blood levels were mea...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1038/sj.bmt.1705481

    authors: Hendriks MP,Blijlevens NM,Schattenberg AV,Burger DM,Donnelly JP

    更新日期:2006-10-01 00:00:00

  • Prevention and treatment of cytomegalovirus infection and disease after bone marrow transplantation in the 1990s.

    abstract::There is substantial progress in preventing and treating cytomegalovirus (CMV) infections and CMV-related disease after allogeneic bone marrow transplantation. In CMV-seronegative recipients, use of CMV-seronegative blood products eliminates most CMV infections. Effective prophylaxis for CMV-seropositive recipients is...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,评审

    doi:

    authors: Winston DJ,Gale RP

    更新日期:1991-07-01 00:00:00

  • Abortive human cytomegalovirus infection in patients after allogeneic bone marrow transplantation.

    abstract::Infection with human cytomegalovirus (HCMV) after allogeneic bone marrow transplantation (BMT) was studied in 12 HCMV seronegative recipients of marrow from seropositive donors by weekly monitoring of cultures, expression of HCMV antigenemia (pp65) in granulocytes, polymerase chain reaction (PCR) on HCMV-DNA in granul...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: de Gast GC,Boland GJ,Vlieger AM,de Weger RA,Verdonck LF,Zwaan FE,Jiwa NM

    更新日期:1992-04-01 00:00:00

  • Histoincompatibilities in ABDR-matched unrelated donor recipient combinations.

    abstract::To get an insight into the degree of major histocompatibility mismatches in donor/recipient (D/R) combinations who were 'ABDR-matched' by serology for class I and by oligotyping for DR1-14 (low resolution typing), we performed additional HLA testing using a combination of molecular, biochemical and cellular techniques...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Rufer N,Tiercy JM,Breur-Vriesendorp B,Gauchat-Feiss D,Shi X,Slavcev A,Lardy N,Speiser D,Gratwohl A,Chapuis B

    更新日期:1995-11-01 00:00:00

  • Long-term oral complications of allogeneic haematopoietic SCT.

    abstract::This study assessed the incidence of long-term oral complications in 88 survivors of allogeneic haematopoietic cell transplantation (HCT). Patients examined were between 6 months and 6 years post-HCT and aged from 19 to 65 years. Subjects were investigated for both the subjective and objective features of long-term ad...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2011.63

    authors: Hull KM,Kerridge I,Schifter M

    更新日期:2012-02-01 00:00:00

  • Are backup BM harvests worthwhile in unrelated donor allogeneic transplants?

    abstract::The Cleveland Clinic blood and marrow transplant program has routinely performed 'backup' autologous harvests in unrelated recipients with hematological malignancies in remission, lymphoma without marrow involvement and CML in chronic phase. We reviewed all adult or cord unrelated donor (URD) transplants performed fro...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2009.95

    authors: Stotler C,Bolwell B,Sobecks R,Dean R,Serafino S,Rybicki L,Andresen S,Pohlman B,Kalaycio M,Copelan E

    更新日期:2010-01-01 00:00:00

  • High probability of long-term survival in 2-year survivors of autologous hematopoietic cell transplantation for AML in first or second CR.

    abstract::We describe the long-term outcomes of autologous hematopoietic cell transplantation (HCT) for 315 AML patients in first or second complete remission (CR). All patients were in continuous CR for ≥2 years after HCT. Patients were predominantly transplanted in CR1 (78%) and had good or intermediate cytogenetic risk disea...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1038/bmt.2010.115

    authors: Majhail NS,Bajorunaite R,Lazarus HM,Wang Z,Klein JP,Zhang MJ,Rizzo JD

    更新日期:2011-03-01 00:00:00

  • Tissue plasminogen activator (tPA) as therapy for hepatotoxicity following bone marrow transplantation.

    abstract::The treatment of established veno-occlusive disease (VOD) of the liver with tissue plasminogen activator (tPA) has been disappointing. In attempts to improve upon these results we identified a subgroup of patients with consistently elevated bilirubin levels who did not meet conventional criteria for VOD (Susp VOD) but...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1038/sj.bmt.1702069

    authors: Schriber J,Milk B,Shaw D,Christiansen N,Baer M,Slack J,Tezcan H,Wetzler M,Herzig G

    更新日期:1999-12-01 00:00:00

  • Umbilical cord blood stem cell transplantation from unrelated HLA-matched donor in an infant with severe congenital neutropenia.

    abstract::We report here a 6-month-old boy with severe congenital neutropenia (SCN) successfully treated by cord blood stem cell transplantation (CBSCT) from an unrelated donor. He had recurrent life-threatening respiratory infection due to severe neutropenia that was refractory to recombinant human granulocyte colony-stimulati...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1704439

    authors: Mino E,Kobayashi R,Yoshida M,Suzuki Y,Yamada M,Kobayashi K

    更新日期:2004-05-01 00:00:00

  • Risk factors for thrombotic microangiopathy in allogeneic hematopoietic stem cell recipients receiving GVHD prophylaxis with tacrolimus plus MTX or sirolimus.

    abstract::Transplantation-associated thrombotic microangiopathy (TA-TMA) is a feared complication of allogeneic hematopoietic SCT (HSCT) owing to its high mortality rate. The use of calcineurin inhibitors or sirolimus (SIR) for GVHD prophylaxis has been suggested as a potential risk factor. However, the impact of tacrolimus (TA...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2014.17

    authors: Labrador J,López-Corral L,López-Godino O,Vázquez L,Cabrero-Calvo M,Pérez-López R,Díez-Campelo M,Sánchez-Guijo F,Pérez-López E,Guerrero C,Alberca I,Del Cañizo MC,Pérez-Simón JA,González-Porras JR,Caballero D

    更新日期:2014-05-01 00:00:00

  • Analysis of remobilization success in patients undergoing autologous stem cell transplants who fail an initial mobilization: risk factors, cytokine use and cost.

    abstract::Inadequate stem cell mobilization is seen in approximately 25% of patients undergoing autotransplantation for hematologic malignancies. Remobilization strategies include chemotherapy/cytokine combinations or high-dose cytokines alone or in combination. From 1/1997 to 7/2002, we remobilized 86 patients who failed an in...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1704486

    authors: Boeve S,Strupeck J,Creech S,Stiff PJ

    更新日期:2004-05-01 00:00:00

  • Effect of granulocyte colony-stimulating factor on hematopoietic recovery after peripheral blood progenitor cell transplantation.

    abstract::To examine the effect of granulocyte colony-stimulating factor (G-CSF) on hematopoietic recovery after high-dose chemotherapy and peripheral blood progenitor cell transplantation (PBPCT), 20 patients with hematologic malignancies were divided into two groups. One group was given G-CSF at a daily dose of 50 micrograms/...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:

    authors: Shimazaki C,Oku N,Uchiyama H,Yamagata N,Tatsumi T,Hirata T,Ashihara E,Okawa K,Goto H,Inaba T

    更新日期:1994-03-01 00:00:00

  • Irradiated allogeneic cells enhance umbilical cord blood stem cell engraftment in immunodeficient mice.

    abstract::Umbilical cord blood (UCB) is a readily available source of hematopoietic stem cells for transplantation. UCB hematopoietic SCT for average- and large-sized patients is often limited by the number of cells available in a single unit. To address this limitation, we performed experiments to determine if adjunctive thera...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2012.69

    authors: Budak-Alpdogan T,Jeganathan G,Lee KC,Mrowiec ZR,Medina DJ,Todd D,Moore D,Bertino JR,Strair R

    更新日期:2012-12-01 00:00:00

  • Admission of bone marrow transplant recipients to the intensive care unit: outcome, survival and prognostic factors.

    abstract::The role of ICU support in BMT patients is controversial. In an era of constrained resources, the use of prognostic factors predicting outcome may be helpful in identifying patients who are most likely (or unlikely) to benefit from this intervention. We attempted to define the survival of patients admitted to ICU foll...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1701158

    authors: Jackson SR,Tweeddale MG,Barnett MJ,Spinelli JJ,Sutherland HJ,Reece DE,Klingemann HG,Nantel SH,Fung HC,Toze CL,Phillips GL,Shepherd JD

    更新日期:1998-04-01 00:00:00