Thiele J, Kvasnicka H M, Dietrich H, Stein G, Hann M, Kaminski A, Rathjen N, Metz K A, Beelen D W, Ditschkowski M, Zander A, Kroeger N
Institute of Pathology, University of Cologne, Joseph-Stelzmannstrasse 9, D-50924 Cologne, Germany.
Histol Histopathol. 2005 Jul;20(3):879-89. doi: 10.14670/HH-20.879.
Scant knowledge exists about the dynamics of fibro-osteosclerotic bone marrow (BM) lesions and regeneration of hematopoiesis following allogeneic peripheral stem cell transplantation (SCT) in chronic idiopathic myelofibrosis. Therefore, an immunohistochemical and morphometric study was performed on BM biopsies in 20 patients before and at standardized intervals (days 30 through 384) following SCT. In responding patients, a total regression of the pretransplant increased fibrosis was completed in the posttransplant period after about six months, while the extent of osteosclerosis did not change significantly during observation time. The quantity of CD61+ megakaryocytes including precursors was strikingly variable after SCT and, by using planimetric methods, atypical microforms exhibiting a dysplastic aspect could be demonstrated. These anomalies may be responsible for posttransplant thrombocytopenia. CD34+ progenitor cells were increased before transplantation, however, their number declined rapidly to normal values in responding patients. Nucleated erythroid precursors revealed a decreased amount before and after SCT accounting for anemia. Large clusters of this cell lineage indicated an initial hematopoietic reconstitution comparable with the expansion of the neutrophil granulopoiesis. Proliferative activity and apoptosis showed an increase until one year after SCT that implied a still regenerating hematopoiesis in keeping with an enhanced cell turnover.
关于慢性特发性骨髓纤维化患者接受异基因外周血干细胞移植（SCT）后纤维性骨硬化性骨髓（BM）病变的动态变化以及造血功能的再生，目前所知甚少。因此，我们对20例患者在SCT前及SCT后标准化时间间隔（第30天至384天）的骨髓活检组织进行了免疫组织化学和形态计量学研究。在有反应的患者中，移植前增加的纤维化在移植后约六个月的时间内完全消退，而骨硬化程度在观察期内未发生显著变化。SCT后，包括前体细胞在内的CD61+巨核细胞数量变化显著，通过平面测量法可发现表现为发育异常的非典型微形态。这些异常可能是移植后血小板减少的原因。移植前CD34+祖细胞数量增加，但在有反应的患者中其数量迅速降至正常水平。有核红细胞前体细胞在SCT前后数量均减少，这导致了贫血。该细胞系的大簇集表明初始造血重建与中性粒细胞生成的增加相当。增殖活性和凋亡在SCT后一年之内均有所增加，这意味着造血功能仍在再生，与细胞更新增强一致。
