Bone Marrow Transplantation sis. There were several autoantibody positive patients who had never had acute or chronic GVHD.Furthermore, in a large study on long-term transplanted patients, 36% had a Karnofsky index Ͻ100% but only a few of them had active cGVHD. 7 This fits with earlier reports that the occurrence of autoantibodies after HSCT does not correlate with cGVHD but might be rather the expression of an abnormal B cell and/or T cell reconstitution. [3][4][5][8][9][10] Therefore, we hypothesize that long-term survivors after allogeneic HSCT are at risk for a skewed immune reconstitution with altered immune response leading to late secondary 'auto'-immune like phenomena. More detailed and longer analyses are needed to confirm our observation.

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