title: Late onset immune pancytopenia following bone marrow transplantation.
abstract: A 17-year-old boy developed autoimmune pancytopenia in the absence of chronic graft-versus-host disease 170 d after allogeneic bone marrow transplantation (BMT) from his HLA identical brother. The anaemia and thrombocytopenia responded to conventional immunosuppressive treatment, but the neutropenia was refractory to this and to splenectomy and subsequent removal of splenic remnant. Following total lymphoid irradiation the neutrophil count rose to low normal levels but thrombocytopenia and anaemia secondary to marrow hypoplasia required transfusion support. Bone marrow function was finally normalized by an additional transfusion of donor marrow without prior immunosuppressive therapy. We conclude that late onset immune pancytopenia post BMT caused by antibodies of probable donor origin may be life threatening in the absence of chronic graft-versus-host disease.
authors.affiliation: Department of Haematology, Royal Postgraduate Medical School, London.
authors.forename: A
authors.initials: A
authors.lastname: Bashey
authors.forename: I
authors.initials: I
authors.lastname: Owen
authors.forename: G F
authors.initials: GF
authors.lastname: Lucas
authors.forename: N W
authors.initials: NW
authors.lastname: Amphlett
authors.forename: M M
authors.initials: MM
authors.lastname: Jones
authors.forename: A
authors.initials: A
authors.lastname: Lawal
authors.forename: M F
authors.initials: MF
authors.lastname: McMullin
authors.forename: P
authors.initials: P
authors.lastname: Mahendra
authors.forename: L A
authors.initials: LA
authors.lastname: Tyfield
authors.forename: J M
authors.initials: JM
authors.lastname: Hows
mesh_terms: D000293:Adolescent; D000741:Anemia, Aplastic / Q000601:surgery; D001323:Autoantibodies / Q000032:analysis; D001327:Autoimmune Diseases / Q000209:etiology*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010198:Pancytopenia / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D013997:Time Factors
chemical_list: D001323:Autoantibodies