title: Monitoring of T-cell repertoire was useful for predicting graft-versus-host disease prognosis in a patient with chronic myelogeneous leukemia after allogeneic bone marrow transplantation.
abstract: We analyzed 24 T-cell receptor (TCR)beta chain subfamilies (Vbeta) and the chimerism of a patient with chronic myelogeneous leukemia who underwent allogeneic bone marrow transplantation (allo-BMT). The patient developed liver dysfunction at day 19 leading to worsening of his condition. He died on day 91 of hepatic failure. Complete donor chimerism was observed after day 19. The average complexity score of TCR-Vbeta, which was low on day 19 (5.50), because much lower on day 82 (3.77). The average value of normal volunteers is 7.69. Neither immunosuppressive therapy nor antiviral therapy was effective to treat his hepatic dysfunction. A liver specimen at autopsy showed necrotic tissue with invasion of lymphocytes under the endothelial cells of the bile ducts. These findings suggest that the liver dysfunction was due to graft-versus-host disease (GVHD). Careful monitoring of chimerism and TCR-Vbeta complexity may help to predict the prognosis of GVHD after allogeneic BMT.
authors.affiliation: Department of Internal Medicine, Hakodate Municipal Hospital, Hakodate, Japan. rtsutsu@nyc.odn.ne.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Tsutsumi
authors.forename: J
authors.initials: J
authors.lastname: Tanaka
authors.forename: H
authors.initials: H
authors.lastname: Minami
authors.forename: M
authors.initials: M
authors.lastname: Musashi
authors.forename: A
authors.initials: A
authors.lastname: Fukushima
authors.forename: T
authors.initials: T
authors.lastname: Kawamura
authors.forename: H
authors.initials: H
authors.lastname: Kanamori
authors.forename: S
authors.initials: S
authors.lastname: Obara
authors.forename: S
authors.initials: S
authors.lastname: Noto
authors.forename: N
authors.initials: N
authors.lastname: Ogura
authors.forename: M
authors.initials: M
authors.lastname: Asaka
authors.forename: M
authors.initials: M
authors.lastname: Imamura
authors.forename: N
authors.initials: N
authors.lastname: Masauzi
mesh_terms: D000328:Adult; D001344:Autopsy; D016026:Bone Marrow Transplantation / Q000276:immunology*; D017809:Fatal Outcome; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000473:pathology / Q000628:therapy*; D019520:Living Donors; D008297:Male; D015166:Monitoring, Immunologic; D011379:Prognosis; D011948:Receptors, Antigen, T-Cell / Q000097:blood; D035781:Siblings; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D014184:Transplantation, Homologous
chemical_list: D011948:Receptors, Antigen, T-Cell