Bone marrow B cell precursor number after allogeneic stem cell transplantation and GVHD development.
Patients without chronic graft-versus-host disease (cGVHD) have robust B cell reconstitution and are able to maintain B cell homeostasis after allogeneic hematopoietic stem cell transplantation (HSCT). To determine whether B lymphopoiesis differs before cGVHD develops, we examined bone marrow (BM) biopsies for terminal deoxynucleotidyl transferase (TdT) and PAX5 immunostaining early post-HSCT at day 30 when all patients have been shown to have high B cell activating factor (BAFF) levels. We found significantly greater numbers of BM B cell precursors in patients who did not develop cGVHD compared with those who developed cGVHD (median = 44 vs 2 cells/high powered field [hpf]; respectively; P < .001). Importantly, a significant increase in precursor B cells was maintained when patients receiving high-dose steroid therapy were excluded (median = 49 vs 20 cells/hpf; P = .017). Thus, we demonstrate the association of BM B cell production capacity in human GVHD development. Increased BM precursor B cell number may serve to predict good clinical outcome after HSCT.
Duke Scholars
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- Transplantation, Homologous
- Transplantation Conditioning
- Steroids
- Stem Cell Transplantation
- Precursor Cells, B-Lymphoid
- PAX5 Transcription Factor
- Middle Aged
- Male
- Lymphopoiesis
- Lymphocyte Count
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Transplantation, Homologous
- Transplantation Conditioning
- Steroids
- Stem Cell Transplantation
- Precursor Cells, B-Lymphoid
- PAX5 Transcription Factor
- Middle Aged
- Male
- Lymphopoiesis
- Lymphocyte Count