Spontaneous graft versus host disease occurring in a patient with multiple myeloma after autologous stem cell transplant

Abstract

, rs9399137, rs7775698, and 3-bp (TAC) deletion, and SNP rs5006884 in OR51B6 was done by PCR, followed by nucleotide sequencing using the BigDye terminator cycle sequencing kit from Applied BioSystems.HBG1-HBD nucleotide sequencing. Short (500-600 bp) and overlapping fragments of DNA covering the 14.1 kb region were amplified by PCR. All PCR reactions were performed in a total volume of 20 ml. Master mix concentrations, and cycling conditions were optimized based on the region being amplified. Usually, each reaction contained 100-250 ng of DNA, 1X PCR buffer (Applied BioSystems), 2 mM MgCl 2 , 200 mM dNTP, 1 ng of each primer, and 0.5U AmpliTaq polymerase. Cycling conditions consisted of 5 min at 948C, followed by 30 cycles of 40 sec at 948C, 40 sec at 558C, and 3 min at 728C and a 7-min elongation step at 728C.Statistical Analysis. Association between HbF and the minor alleles of each QTL was statistically analyzed by the Fisher exact test performed in R (www.r-project.org). Comparison of hematological parameters and correlation between NOMAP and HbF in both groups was examined using paired T-test. An overall significance level of 0.05 was set for all statistical analyses.

Isolated Gastrointestinal Graft versus Host Disease in a Patient of Multiple Myeloma after Autologous Hematopoietic Stem Cell Transplantation

“…Four of these 5 patients ultimately expired due to complications attributed to steroid-refractory GI GVHD [3]. Amongst isolated case reports, Fidler, et al described a case of auto-GVHD with skin and gastrointestinal manifestations in a patient with MM, who ultimately deteriorated and expired despite steroid therapy [5]. Recently, Barbash, et al described a case of spontaneous GI GVHD with predominant upper GI involvement in a patient of multiple myeloma who underwent autologous HSCT [6].…”

Skin Graft-versus-host Disease Following Autologous Stem Cell Transplantation for Multiple Myeloma

“…Auto-GVHD is generally self-limited and often requires no treatment (8-10). In contrast, several case reports have described patients presenting with severe and ultimately fatal spontaneous auto-GVHD (2-4). In particular, individuals treated with ASCT for multiple myeloma (MM) may develop potentially life-threatening syndromes which are pathologically identical to allogeneic GVHD.…”

“…However, a similar syndrome has been reported in autologous stem cell transplantation (ASCT), without induction of an alloresponse, as a form of 'auto-aggression' syndrome or autologous GVHD (auto-GVHD) (1). Although there is no genetic disparity in GVHD development among patients undergoing ASCT, auto-GVHD has been reported to arise either spontaneously (2-5) or in patients receiving immunologic modulation (6,7). Auto-GVHD is generally self-limited and often requires no treatment (8-10).…”

“…In particular, individuals treated with ASCT for multiple myeloma (MM) may develop potentially life-threatening syndromes which are pathologically identical to allogeneic GVHD. Fidler et al (2) described a case of auto-GVHD with skin and GI manifestations in a patient with MM, who ultimately deteriorated and expired due to auto-GVHD. Another case series by Drobyski et al (3) described 5 patients who developed clinical syndrome consistent with auto-GVHD.…”

Autologous Graft versus Host Disease: An Emerging Complication in Patients with Multiple Myeloma

“…However, it is rarely seen in recipients of autologous cells, and would likely have a very different etiology as no alloantigens are introduced to the hosts. Recently, clusters of multiple myeloma (MM) patients who developed autologous graft versus host disease (autoGVHD) after receiving autologous hematopoietic progenitor cell (HPC) transplantation have been reported [1–3]. Patients with MM maybe more susceptible to developing autoGVHD as 5 cases were reported among 223 MM patients, but none in 136 patients who underwent autologous HPC transplantation for Hodgkin disease, acute myeloid leukemia, and non-Hodgkin lymphoma developed the complication [1].…”