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Cellular composition of the spleen after human allogeneic bone marrow transplantation

✍ Scribed by Susan A. Dilly; Dr. John P. Sloane


Publisher
John Wiley and Sons
Year
1988
Tongue
English
Weight
950 KB
Volume
155
Category
Article
ISSN
0022-3417

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✦ Synopsis


The cellular composition of the spleen has been assessed in 18 patients who died 15-326 days after receiving allogeneic marrow for leukaemia. The white pulp showed marked lymphocyte depletion with no germinal centres, very few B cells, and rare plasma cells. The marginal zone was unrecognizable but there were moderate numbers of T cells in the periarteriolar lymphatic sheaths (PALS), showing great variation in CD4/CD8 ratio. The percentage of CD4+ cells decreased with time post transplant. CD8+ cells were reduced in patients with graft-versus-host disease (GvHD) who also showed no increase in cells staining for activation markers. No T cells were detected expressing immature phenotypes and no differences were detected between patients who received marrow purged or unpurged of T cells. Macrophage numbers appeared normal. Extramedullary haemopoiesis (EMH) was predominantly in the red pulp greater than 30 days after transplantation but more commonly in the white pulp before then. Pyknotic cells were common in seven cases and appeared to be associated with EMH rather than GvHD. Chimaeric studies demonstrated small numbers of donor cells in the PALS at 26 days and larger numbers at 56 days.


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Allogeneic stem cell transplantation is considered to be a curative treatment modality in patients with chronic myelogenous leukemia. However patients are at risk for relapse years after transplantation. Currently we present two patients who relapsed 16 and 24 years after allogeneic bone marrow tran