Expansion of a clonal CD8+CD57+ large granular lymphocyte population after autologous stem cell transplant in multiple myeloma.
Clonal expansions of large granular lymphocytes (LGLs) have been identified in patients following stem cell transplants and may represent posttransplant LGL leukemias or reactive immune responses. To differentiate between these 2 possibilities, we assessed peripheral blood and bone marrow of patients with myeloma after autologous stem cell transplant. All patients examined shortly after autologous stem cell transplant had significant increases in the LGLs in the peripheral blood and bone marrow (71% of lymphocytes) as compared with controls (39%). This increase was detectable years after transplant. The LGLs had a reproducible immunophenotype of CD8+CD57+ T cells without phenotypic abnormalities in 19 of 20 patients. Sixty-five percent of the post-autologous stem cell transplant patients had clonal T-cell receptor gene rearrangements in the bone marrow, yet no patients had neutropenia or splenomegaly. Although the LGL expansions were clonal and persistent, the lack of clinical sequelae suggests the clonal LGL expansion is a reactive, potentially beneficial, immune response to autologous stem cell transplant.
Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA. k-wolniak@northwestern.edu
Kristy L
KL
Wolniak
Charles L
CL
Goolsby
Y-Hua
YH
Chen
Anjen
A
Chenn
Seema
S
Singhal
JayeshMehta
Lo Ann C
LA
Peterson
D001854:Bone Marrow Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D018959:CD57 Antigens / Q000378:metabolism*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology*; D049109:Cell Proliferation; D002999:Clone Cells / Q000473:pathology; D005434:Flow Cytometry; D015329:Gene Rearrangement, T-Lymphocyte / Q000235:genetics; D006801:Humans; D007113:Immunity, Innate / Q000235:genetics / Q000276:immunology; D016130:Immunophenotyping; D054066:Leukemia, Large Granular Lymphocytic / Q000276:immunology / Q000473:pathology*; D008218:Lymphocytosis / Q000473:pathology*; D009101:Multiple Myeloma / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D011183:Postoperative Complications; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous
D018959:CD57 Antigens