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Monoclonal and oligoclonal gammopathy after bone marrow transplantation
AJ Mitus, R Stein, JM Rappeport, JH Antin, HJ Weinstein, CA Alper and BR Smith
Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Serial serum protein electrophoreses were performed on 60 patients
undergoing allogeneic and syngeneic bone marrow transplantation (BMT). More
than 50% of patients (31 of 60) developed transient oligoclonal and
monoclonal gammopathies that appeared an average of 84 days
posttransplantation (range 27 to 336 days) and persisted an average of 175
days (range 14 to 652 days). Immunofixation analysis revealed 82% of the M
components to be of the immunoglobulin G (IgG) type and 18% to be IgM; 56%
were kappa and 44% were lambda. A strong correlation between development of
graft versus host disease (GVHD) and appearance of M components was
observed (73% incidence in GVHD patients v 27% in non-GVHD patients, P =
.0003). Two of the three syngeneic graft recipients also developed
monoclonal gammopathies. Evidence of oligoclonal circulating B-cell
populations was found in 68% of patients posttransplantation by flow
cytometric B-cell clonal excess assay. No correlation of recovery of
particular B- or T-lymphocyte subsets and development of M components was
seen. The development of transient oligoclonal and monoclonal gammopathies
after transplantation may be a ubiquitous finding reflecting recapitulation
of early B-cell ontogeny.
Volume 74,
Issue 8,
pp. 2764-2768,
12/01/1989
Copyright © 1989 by The American Society of Hematology
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