Nagashima Takahiro, Muroi Kazuo, Kawano-Yamamoto Chizuru, Komatsu Norio, Ozawa Keiya
Division of Cell Transplantation and Transfusion, 3311-1 Yakushiji, Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-0498, Japan.
Leuk Lymphoma. 2004 Jan;45(1):135-7. doi: 10.1080/1042819031000139729.
The frequency and clinical significance of paraproteinemia in patients receiving hematopoietic stem cell (HSC) transplants were assessed. Of 66 patients with hematologic malignancies, excluding multiple myeloma who received an allogeneic or autologous HSC transplant, paraproteins were detected in 12 patients using immunoelectrophoresis. None of the patients showed paraproteinemia before HSC transplantation. The class of paraproteins most commonly seen was IgG. In 9 of these 12 patients (75%), a paraprotein was detected continuously after HSC transplantation for an average duration of 464 days, while others demonstrated a transient appearance of the protein. Paraproteinemia after HSC transplantation was not related to the stem cell source, (allograft vs. autograft), age, gender, viral infection and graft-vs.-host disease (GVHD). None of the patients developed plasma cell dyscrasia after the appearance of the paraprotein, while 1 patient developed secondary acute lymphoblastic leukemia. These findings indicate that paraproteinemia after HSC transplantation may be caused by an aberrant immune reconstitution after both allogeneic and autologous HSC transplantation. A long-term follow-up of patients with paraproteinemia after HSC transplantation is needed to confirm this finding in a larger series of patients.
评估了接受造血干细胞（HSC）移植患者中副蛋白血症的发生率及其临床意义。在66例血液系统恶性肿瘤患者中，排除接受异基因或自体HSC移植的多发性骨髓瘤患者，采用免疫电泳法在12例患者中检测到副蛋白。在HSC移植前，所有患者均未出现副蛋白血症。最常见的副蛋白类型为IgG。在这12例患者中的9例（75%），HSC移植后持续检测到副蛋白，平均持续时间为464天，而其他患者的副蛋白呈短暂出现。HSC移植后的副蛋白血症与干细胞来源（同种异体移植与自体移植）、年龄、性别、病毒感染及移植物抗宿主病（GVHD）无关。在出现副蛋白后，无一例患者发生浆细胞发育异常，而有1例患者发生了继发性急性淋巴细胞白血病。这些发现表明，HSC移植后的副蛋白血症可能是由异基因和自体HSC移植后异常的免疫重建所致。需要对HSC移植后发生副蛋白血症的患者进行长期随访，以在更多患者中证实这一发现。
