0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Functional Asplenia after Bone Marrow Transplantation: A Late Complication Related to Extensive Chronic Graft-Versus-Host Disease

Peter Kalhs, MD; Simon Panzer, MD; Kurt Kletter, MD, PhD; Erich Minar, MD; Milena Stain-Kos, MD; Reinhard Walter, MD; Klaus Lechner, MD; and Wolfgang Hinterberger, MD
[+] Article and Author Information

Grant Support: Partial support by grants from the Medizinish-Wissenschaftlicher Fonds des Bürgermeisters der Bundeshauptstadt Wein. Dr. Stain-Kos was the recipient of grants from the Kommission für Leukämieforschung und Knochenmarktransplantation of the Austrian Academy of Sciences.

Requests for Reprints: Peter Kalhs, MD, First Medical Clinic, Division of Hematology, University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria.

Current Author Addresses: Drs. Kalhs, Panzer, Kletter, Minar, Stain-Kos, Walter, Lechner, and Hinterberger: First Medical Clinic, University of Vienna, Vienna, Austria.


© 1988 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1988;109(6):461-464. doi:10.7326/0003-4819-109-6-461
Text Size: A A A

Study Objective: To evaluate splenic function in bone marrow transplant recipients, with relation to chronic graft-versus-host disease and infections.

Design: Survey, outpatients geographically accessible for voluntary participation.

Setting: Bone marrow transplantation referral center.

Patients: Fifteen bone marrow graft recipients (13 allogeneic, 2 autologous), out of a total of 33 patients who received transplants at the center and survived more than 6 months after grafting.

Measurements and Main Results: In 6 of 15 patients impaired splenic function (functional asplenia) was indicated by the presence of Howell-Jolly bodies in peripheral blood smears, reduced spleen size (P < 0.001), higher platelet counts (P < 0.01), higher indium-111 labeled autologous platelet recovery (P < 0.005), reduced splenic blood flow (P < 0.001), and reduced accumulation of radioactivity at the splenic site (P < 0.001). All patients with functional asplenia but only 2 patients without functional asplenia had extensive chronic graft-versus-host disease. The incidence of bacterial infections was four times higher in patients with impaired splenic function.

Conclusions: Functional asplenia is a late complication after allogeneic bone marrow transplantation and contributes to the high susceptibility to bacterial infections in patients with extensive chronic graft-versus-host disease.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)