Abstract
Five recipients of BMT at the Children's Hospital of Philadelphia developed late bacterial infections. This prompted us to review our clinical experience seeking evidence for splenic hypofunction in those and other patients (pts). Accordingly, we sought Howell-Jolly bodies (HJB) in peripheral blood smears of 29 pts; performed liver-spleen scans (LSS) in 9 pts with chronic graft-vs-host disease (CGVHD) and/or infection; and reviewed the spleens of 7 pts who died and had autopsies. In our series as a whole, 12 pts developed GVHD (5 acute; 2 chronic; 5 acute and chronic). 7/29 pts developed HJB; 4 of these had GVHD. Four pts receiving LSS showed decreased or absent splenic function; 3 had GVHD. The incidence of HJB or decreased function on LSS was not related to underlying diagnosis or preparative regimen. Lymphoid depletion was evident on all 7 spleens whose histopathology was reviewed: 2 showed total; 3 marked; and 2 moderately depleted lymphoid tissue. Our retrospective data suggest that splenic hypofunction is fairly common in the recipients of BMT, especially in pts with GVHD. Prospective studies performed at regular intervals after BMT will be necessary to define the true incidence of this condition and identify those pts who may need prophylactic antibiotic therapy.
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Serota, F., Greenbaum, B., Heyman, S. et al. 868 SPLENIC HYPOFUNCTION OF PATIENTS UNDERGOING BONE MARROW TRANSPLANTATION (BMT). Pediatr Res 15 (Suppl 4), 587 (1981). https://doi.org/10.1203/00006450-198104001-00893
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DOI: https://doi.org/10.1203/00006450-198104001-00893