Peter Kalhs, MD; Simon Panzer, MD; Kurt Kletter, MD, PhD; Erich Minar, MD; Milena Stain-Kos, MD; Reinhard Walter, MD; Klaus Lechner, MD; Wolfgang Hinterberger, MD
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.
Kalhs P, Panzer S, Kletter K, Minar E, Stain-Kos M, Walter R, et al. Functional Asplenia after Bone Marrow Transplantation: A Late Complication Related to Extensive Chronic Graft-Versus-Host Disease. Ann Intern Med. ;109:461–464. doi: 10.7326/0003-4819-109-6-461
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Published: Ann Intern Med. 1988;109(6):461-464.
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