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Plasmacellular hyperplasia after allogeneic bone marrow transplantation.

H J Schuurman¹, R A de Weger, R W Hendriks

¹Department of Internal Medicine, University Hospital, Utrecht, The Netherlands.

Cancer Detection and Prevention

|January 1, 1988

Summary

Monotypic B lymphoid cells, expressing a single immunoglobulin type, were found in patients post-bone marrow transplant. DNA analysis revealed these cells represent a polyclonal B cell expansion, not a clonal malignancy.

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Area of Science:

Immunology
Hematology
Oncology

Background:

Allogeneic bone marrow transplantation (BMT) can lead to complex immune reconstitution and potential lymphoid abnormalities.
Monotypic immunoglobulin (Ig) expression in B lymphoid cells typically suggests a neoplastic process.

Observation:

B lymphoid cells with monotypic Ig expression were identified in 5 out of 9 patients following allogeneic BMT.
Observed conditions included plasmacellular hyperplasia of lymph nodes and spleen, immunoblastic transformation in lymph nodes, and a gastrointestinal immunoblastic lymphoma.

Findings:

Detailed immunophenotypic and histologic analysis was performed on lymphoid tissues from three patients.
DNA analysis using JH-gene and light chain probes did not reveal single Ig gene rearrangements.

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The monotypic B lymphoid elements were determined to represent a polyclonal B cell expansion.

Implications:

This finding challenges the assumption that monotypic Ig expression post-BMT invariably indicates malignancy.
Understanding the nature of these polyclonal expansions is crucial for accurate diagnosis and patient management after transplantation.
Further research is needed to elucidate the mechanisms driving polyclonal B cell expansion with monotypic Ig expression in the context of BMT.