Post-hematopoietic stem cell transplantion immune-mediated cytopenias.
Immune-mediated cytopenias after allogeneic stem cell transplantation can be categorized as either alloimmune when host or donor immunity reacts against donor or host elements, respectively, or autoimmune when donor immunity reacts against donor hematopoietic tissue, owing to poorly understood mechanisms that result in severe impairment of central and peripheral tolerance. Immune cytopenias are manifested as monolineage or more rarely as bilineage cytopenias, and are usually mediated through humoral immune mechanisms. On the contrary, immune-mediated pancytopenia is a rare event with only few cases reported in the literature. The exact pathogenesis of immune pancytopenia is not well known although it is possible that cellular immunity may play a significant role. The importance of these syndromes lies in the fact that they can cause severe morbidity and mortality. Differential diagnosis from other causes of post-transplant pancytopenia is of extreme value because these disorders can respond to various treatment modalities.
Tsirigotis
Panagiotis D
PD
Department of Bone Marrow Transplantation & Cancer Immunotherapy, Hadassah, Israel.
Resnick
Igor B
IB
Or
Reuven
R
Elad
Sharon
S
Zilberman
Irina
I
Yoffe
Luba
L
Levovic
Alexander
A
Miron
Svetlana
S
Gesundheit
Benjamin
B
Slavin
Shimon
S
Shapira
Michael-Yechiel
MY
D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D046528:Chimerism; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes; D009503:Neutropenia; D011183:Postoperative Complications; D012010:Red-Cell Aplasia, Pure; D012074:Remission Induction; D013921:Thrombocytopenia; D019172:Transplantation Conditioning
D016756:Immunoglobulins, Intravenous; D016572:Cyclosporine