Related Experiment Videos
Multiple autoimmune events after autologous bone marrow transplantation
G L Lambertenghi-Deliliers1, C Annaloro, A Della Volpe
1Centro Trapianti di Midollo, Ospedale Maggiore IRCCS, Milan, Italy.
Bone Marrow Transplantation
|April 1, 1997
Summary
A patient with high-risk myelodysplastic syndrome achieved long-term remission after stem cell transplant. She developed multiple autoimmune conditions post-transplant, which resolved, aiding disease control.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Autologous bone marrow transplantation (BMT) is a treatment for high-risk myelodysplastic syndromes (MDS).
- Graft-versus-host disease (GVHD) is a common complication after allogeneic BMT, but GVHD-like reactions can occur in autologous settings.
- Polymorphic autoimmune events can arise post-transplant, even without systemic autoimmune disease.
Observation:
- A 36-year-old woman with RAEB-t and severe bone marrow fibrosis developed a GVHD-like skin rash after autologous BMT.
- Subsequently, she was diagnosed with autoimmune thyroiditis, autoimmune thrombocytopenic purpura, autoimmune hemolytic anemia, and a lupus anticoagulant (LAC).
Findings:
- The patient achieved a complete remission (CR) and remains symptom-free with long-term disease-free survival (DFS).
- Autoantibodies, except anti-erythrocyte antibodies, remained detectable despite immunosuppressive therapy.
- The polymorphic autoimmune events, in the absence of systemic autoimmune disease, were a notable feature.
Implications:
- This case highlights the potential for complex autoimmune complications following autologous BMT in high-risk MDS patients.
- The resolution of autoimmune events and potential graft-versus-leukemia (GVL) effect may have contributed to sustained disease control.
- Long-term DFS is achievable despite significant post-transplant autoimmune sequelae.