一名异基因骨髓移植受者体内的单型免疫球蛋白E浆细胞

Monotypic immunoglobulin E plasma cells in an allogeneic bone marrow transplant recipient.

作者信息

Schuurman H J, Verdonck L F, Geertzema J G, van der Linden J A, de Gast G C

出版信息

Histopathology. 1986 Sep;10(9):963-9. doi: 10.1111/j.1365-2559.1986.tb02594.x.

DOI:10.1111/j.1365-2559.1986.tb02594.x

Abstract

A patient with acute lymphoblastic leukaemia in first remission received a bone marrow transplant from his HLA-identical brother. The patient had a remote history of asthma and the bone marrow donor had allergic asthma. The patient developed acute graft-versus-host disease and died 2 months after transplantation. At autopsy there were high numbers of plasma cells in lymphoid tissues. The majority of this cell population was of polytypic IgG, IgM or IgA origin, but there was a significant contribution by monotypic IgE-lambda-containing cells, varying from 10% in the appendix to 35% in lymph node. The serum IgE level in the patient was less than 0.5 IU/ml before transplantation, and 8.5 IU/ml 1 month thereafter. In the donor the value was about 400 IU/ml. In the donor only, specific IgE antibodies to various allergens were detectable. The bone marrow of the donor contained 0.4% plasma cells, of which 36% were IgE positive (chi/lambda ratio 1/11). These findings are compatible with literature data on elevations in serum IgE level following bone marrow transplantation. We suggest that the IgE-lambda plasma cell population is of donor origin.

摘要

一名处于首次缓解期的急性淋巴细胞白血病患者接受了来自其 HLA 配型相同的兄弟的骨髓移植。该患者有哮喘病史，骨髓供者有过敏性哮喘。患者发生了急性移植物抗宿主病，并在移植后 2 个月死亡。尸检时，淋巴组织中有大量浆细胞。该细胞群体大多数起源于多型性 IgG、IgM 或 IgA，但含单型 IgE-λ 的细胞有显著贡献，在阑尾中占 10%，在淋巴结中占 35%。移植前患者血清 IgE 水平低于 0.5 IU/ml，移植后 1 个月为 8.5 IU/ml。供者的该值约为 400 IU/ml。仅在供者体内可检测到针对各种变应原的特异性 IgE 抗体。供者的骨髓含有 0.4%的浆细胞，其中 36%为 IgE 阳性（κ/λ 比值为 1/11）。这些发现与骨髓移植后血清 IgE 水平升高的文献数据相符。我们认为 IgE-λ 浆细胞群体起源于供者。