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Bone Marrow Research
Volume 2014, Article ID 891427, 7 pages
http://dx.doi.org/10.1155/2014/891427
Clinical Study

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

1Division of Hematology and Oncology, Department of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 508, Little Rock, AR 72205, USA
2Department of Pathology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 823, Little Rock, AR 72205, USA
3Department of Pathology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 502, Little Rock, AR 72205, USA

Received 21 February 2014; Accepted 2 April 2014; Published 4 May 2014

Academic Editor: Paolo De Fabritiis

Copyright © 2014 Anu Batra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Autologous graft versus host disease (autoGVHD) is a rare transplant complication with significant morbidity and mortality. It has been hypothesized that patients with multiple myeloma might be predisposed to autoGVHD through dysregulation of the immune response resulting from either their disease, the immunomodulatory agents (IMiDs) used to treat it, or transplant conditioning regimen. Hematopoietic progenitor cell (HPC) products were available from 8 multiple myeloma patients with biopsy-proven autoGVHD, 16 matched multiple myeloma patients who did not develop autoGVHD, and 7 healthy research donors. The data on number of transplants prior to developing autoGVHD, mobilization regimens, exposure to proteasome inhibitors, use of IMiDs, and class I human leukocyte antigen types (HLA A and B) were collected. The HPC products were analyzed by flow cytometry for expression of CD3, CD4, CD8, CD25, CD56, and FoxP3. CD3+ cell number was significantly lower in autoGVHD patients compared to unaffected controls (). On subset analysis of CD3+ cells, CD8+ cells (but not CD4+ cells) were found to be significantly lower in patients with autoGVHD (). HLA-B55 expression was significantly associated with development of autoGVHD (). Lower percentages of CD3+ and CD8+ T-cells and HLA-B55 expression may be predisposing factors for developing autoGVHD in myeloma.