1995
DOI: 10.1111/j.1365-2141.1995.tb05311.x
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Diagnosis of transfusion‐associated graft‐versus‐host disease by polymerase chain reaction in fludarabine‐treated B‐chronic lymphocytic leukaemia

Abstract: Transfusion-associated graft-versus-host disease (TA-GVHD), has rarely been reported associated with B-chronic lymphocytic leukaemia (B-CLL). We report a patient diagnosed with B-CLL, previously treated with fludarabine, who developed TA-GVHD after being transfused during surgery for splenectomy. Diagnosis was confirmed by polymerase chain reaction (PCR) detection of donor DNA in the patient, by amplification of Y-chromosome sequence and analysis of minisatellite polymorphisms. B-CLL patients treated with flud… Show more

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Cited by 28 publications
(18 citation statements)
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“…15 PCR amplification of hypervariable regions is often used to study post-transplantation chimerism; 4 it has also occasionally aided in the diagnosis of transfusion-associated GVHD by detection of blood donor DNA. 16 Likewise, in cases of severe GVHD after cord blood transplantation, chimerism studies should be done to assess the fetal or maternal origin of the lymphocytes responsible.…”
Section: Discussionmentioning
confidence: 99%
“…15 PCR amplification of hypervariable regions is often used to study post-transplantation chimerism; 4 it has also occasionally aided in the diagnosis of transfusion-associated GVHD by detection of blood donor DNA. 16 Likewise, in cases of severe GVHD after cord blood transplantation, chimerism studies should be done to assess the fetal or maternal origin of the lymphocytes responsible.…”
Section: Discussionmentioning
confidence: 99%
“…Clinical data in humans have shown that fludarabine in combination with other agents is highly effective as Fludarabine and transplantation in murine leukemia L Weiss et al cytoreductive treatment for lymphoid leukemias, and can also cause host immunomodulation as well as sufficient immunosuppression for successful allotransplantation. 15,18,19 Indeed fludarabine has already become accepted as the anchor drug in these combination regimens for successful non-myeloablative stem cell transplantation in leukemias, lymphoma and in other malignancies. [19][20][21][22] Despite the successful use of fludarabine in humans, until recently there is very little experimental evidence-based available data in animals that can be used as a parallel for the successful experience in human leukemia and transplantation.…”
Section: Discussionmentioning
confidence: 99%
“…Furthermore, the immunomodulatory effect of fludarabine is also evident in CLL patients who may develop auto-immune hemolytic anemia, suggesting imbalance between B and T cell subsets arising during treatment. 26 Very rarely other patients may acquire transfusion-associated GVHD, [27][28][29] indicating purine analogueinduced elimination of the recipient's GVHD-abortive capacity of allogeneic cells. 30 It is indeed feasible that fludarabine may affect antigen-presenting cells or monocytes, or even have a polarizing influence on Th1 and Th2 helper lymphocyte subsets in the host, 14,18 all of which may be implicated in the pathogenesis of auto-or alloimmune phenomena.…”
Section: Discussionmentioning
confidence: 99%