PMID- 27932186
OWN - NLM
STAT- MEDLINE
DCOM- 20170426
LR  - 20181202
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 48
IP  - 9
DP  - 2016 Nov
TI  - Late Graft Rejection in Association With T-Large Granular Lymphocyte Expansion of 
      Recipient Origin After Human Leukocyte Antigen-Haploidentical Stem Cell 
      Transplantation: A Case Report.
PG  - 3222-3224
LID - S0041-1345(16)30329-3 [pii]
LID - 10.1016/j.transproceed.2016.06.037 [doi]
AB  - BACKGROUND: Large granular lymphocyte (LGL) expansion occasionally occurs after 
      allogeneic stem cell transplantation (allo-SCT), and is thought to be a good 
      prognostic sign that is associated with a lower relapse rate. However, there have 
      been no reports of late graft failure (LGF) due to graft rejection in association 
      with oligoclonal LGL expansion. We herein report a case of LGF associated with 
      the transient expansion of recipient-derived T-LGL after allo-SCT. CASE REPORT: A 
      65-year-old man underwent peripheral blood stem cell transplantation (PBSCT) from 
      his human leukocyte antigen (HLA)-haploidentical son for the treatment of acute 
      myeloid leukemia, which had evolved from a myelodysplastic syndrome (MDS). 
      Neutrophil engraftment occurred on day 20. A chimerism analysis on day 29 showed 
      both granulocytes and mononuclear cells in the peripheral blood to be completely 
      of donor origin. However, his neutrophil count gradually decreased and a 
      chimerism analysis on day 61 showed that 84% of the patient's T cells were of 
      recipient origin while the granulocytes were 100% donor-derived. His LGLs rapidly 
      increased to 4.01 x 10(9)/L on day 113 and decreased thereafter. The percentage 
      of donor cells in his granulocytes gradually decreased, and the patient's 
      leukocytes were completely replaced by recipient cells on day 177. CONCLUSIONS: 
      The clinical course suggests that the expansion of recipient-derived T-LGLs after 
      allo-SCT can be a sign of graft rejection. Early intervention may be needed if 
      the LGL expansion is recipient-derived.
CI  - Copyright A(c) 2016 Elsevier Inc. All rights reserved.
FAU - Nakagawa, N
AU  - Nakagawa N
AD  - Cellular Transplantation Biology, Kanazawa University Graduate School of Medical 
      Science, Kanazawa, Japan.
FAU - Yamazaki, H
AU  - Yamazaki H
AD  - Cellular Transplantation Biology, Kanazawa University Graduate School of Medical 
      Science, Kanazawa, Japan.
FAU - Aoki, G
AU  - Aoki G
AD  - Cellular Transplantation Biology, Kanazawa University Graduate School of Medical 
      Science, Kanazawa, Japan.
FAU - Kondo, Y
AU  - Kondo Y
AD  - Cellular Transplantation Biology, Kanazawa University Graduate School of Medical 
      Science, Kanazawa, Japan.
FAU - Nakao, S
AU  - Nakao S
AD  - Cellular Transplantation Biology, Kanazawa University Graduate School of Medical 
      Science, Kanazawa, Japan. Electronic address: snakao8205@staff.kanazawa-u.ac.jp.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (HLA Antigens)
RN  - 0 (Histocompatibility Antigens Class II)
SB  - IM
MH  - Aged
MH  - Chimerism
MH  - Female
MH  - Graft Rejection/*immunology
MH  - Graft vs Host Disease/*immunology
MH  - HLA Antigens/analysis
MH  - Histocompatibility Antigens Class II
MH  - Humans
MH  - Leukemia, Myeloid, Acute/*surgery
MH  - Male
MH  - Peripheral Blood Stem Cell Transplantation/*adverse effects
MH  - T-Lymphocytes/immunology/*pathology
MH  - Tissue Donors
MH  - Transplantation, Homologous/adverse effects
EDAT- 2016/12/10 06:00
MHDA- 2017/04/27 06:00
CRDT- 2016/12/10 06:00
PHST- 2016/02/03 00:00 [received]
PHST- 2016/04/28 00:00 [revised]
PHST- 2016/06/21 00:00 [accepted]
PHST- 2016/12/10 06:00 [entrez]
PHST- 2016/12/10 06:00 [pubmed]
PHST- 2017/04/27 06:00 [medline]
AID - S0041-1345(16)30329-3 [pii]
AID - 10.1016/j.transproceed.2016.06.037 [doi]
PST - ppublish
SO  - Transplant Proc. 2016 Nov;48(9):3222-3224. doi: 
      10.1016/j.transproceed.2016.06.037.