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Published on: May 27, 2011
Increased polyclonal CD5+ B1a lymphocytes in a haploidentical stem cell transplant recipient
Robert A Hillard1, Lazaros J Lekakis, Joseph F Pulliam
1Department of Pathology and Laboratory Medicine, Chandler Medical Center, University of Kentucky College of Medicine, Lexington, Kentucky 40536, USA. rahill5@email.uky.edu
Following a stem cell transplant, an unusual increase in CD5+ B-cells (B1a cells) was observed. This finding highlights the importance of distinguishing these cells from lymphoproliferative disorders in transplant patients.
Area of Science:
- Immunology
- Hematology
- Transplantation medicine
Background:
- Atypical lymphocyte populations can occur after transplantation.
- This case report details an exceptionally high count of CD5+ B-cells (B1a cells) post-transplant.
Observation:
- B1a cells were identified via immunophenotypic analysis during routine follow-up.
- The patient was a middle-aged male who underwent haploidentical stem cell transplant for acute myeloid leukemia.
- These B1a cells were compared to a reference set of post-transplant samples.
Findings:
- An increased, yet polyclonal, population of B1a cells was detected.
- 100% donor chimerism was confirmed in the patient.
- The CD5+ B lymphocytes were of donor origin and prominent 7 months post-transplant.
Implications:
- Elevated B1a cell counts post-transplant are possible and should not be misdiagnosed as CD5+ lymphoproliferative disorders.
- The recipient's stromal environment does not impede the maintenance of donor CD5+ B1 cells before their conversion to CD5- B2 cells.
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