Spontaneous @entity2132 in plasma cell XXXX autograft recipients: flow cytometric analysis of hematopoietic progenitor cell grafts.

@entity1 @entity8 @entity2816 @entity1582 @entity288 @entity37164 @entity2132 @entity6985 @entity1749 @entity2280 @entity12627 @entity436
Nine plasma cell @entity1582 @entity1 spontaneously developed histologically proven @entity2132 ( @entity2132 ) limited predominantly to the gastrointestinal tract within 1 month of initial @entity8 ( @entity8 ) using high-dose melphalan conditioning. All recipients responded promptly to systemic and nonabsorbable oral corticosteroid therapy. All @entity1 previously received systemic therapy with @entity2816 , @entity6985 , or @entity1749 before @entity8 . Using enzymatic amplification staining-enhanced flow cytometry, we evaluated expression of selected transcription regulators, pathway molecules, and surface receptors on samples of the infused hematopoietic cell grafts. We demonstrated significantly enhanced expression of @entity12627 , @entity37164 , and @entity436 on @entity2280 (+) hematopoietic progenitor cells of affected @entity1 compared with 42 unaffected @entity8 controls. These 3 overexpressed markers have not been previously implicated in autologous @entity2132 . Although we did not specifically evaluate T cells, we postulate that exposure over time to the various immunomodulating therapies used for induction treatment affected not only the @entity2280 (+) cells but also T cells or relevant T cell subpopulations capable of mediating @entity2132 . After infusion, the affected hematopoietic progenitor cells then encounter a host that has been further altered by the high-dose melphalan preparative regimen; such a situation leads to the syndrome. These surface markers could be used to develop a model to predict development of this syndrome. Autologous @entity2132 potentially is a serious complication of @entity8 and should be considered in plasma cell @entity1582 @entity1 with otherwise unexplained gastrointestinal symptoms in the immediate post- @entity8 period. Prompt recognition of this condition and protracted treatment with nonabsorbable or systemic @entity288 or the combination may lead to resolution.
