Yuri Fedoriw, T. Danielle Samulski, Allison M. Deal, Cherie H

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Bone Marrow B cell Precursor Number after Allogeneic Stem Cell Transplantation and GVHD Development  Yuri Fedoriw, T. Danielle Samulski, Allison M. Deal, Cherie H. Dunphy, Andrew Sharf, Thomas C. Shea, Jonathan S. Serody, Stefanie Sarantopoulos  Biology of Blood and Marrow Transplantation  Volume 18, Issue 6, Pages 968-973 (June 2012) DOI: 10.1016/j.bbmt.2012.03.005 Copyright © 2012 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Morphologic and immunohistochemical analysis of day-30 post-hematopoietic stem cell transplantation (HSCT) bone marrow (BM) biopsies in patients who never developed or who developed chronic graft-versus-host disease (cGVHD). (A) Representative micrograph of terminal deoxynucleotidyl transferase (TdT) immunohistochemical staining in patients who never developed (“No cGVHD”) or who subsequently developed cGVHD (“Yes cGVHD”). (B) Absolute numbers of TdT+ BM B cell precursors in patients who never developed (−) vs those who later developed (+) cGVHD, in relation to steroid therapy at the time of BM evaluation (+ vs − steroid). Reference BM (“No HSCT”) showed significantly fewer precursors compared to the + or − cGHVD group after steroid effect was excluded (*P = .03 and P < .01, respectively). (C) Representative micrograph or PAX5 immunohistochemical staining in patients who never developed (“No cGVHD”) or who develop cGVHD (“Yes cGVHD”). (D) Total BM B cell number as determined by PAX5 staining in patients who never developed (−) vs those who developed (+) cGVHD, currently (+), or never treated with (−) steroids. Compared to the reference samples (“No HSCT”), total B cell numbers were similar between patients who had undergone HSCT; NS indicating not significant. (E) Representative micrograph of CD3 immunohistochemical staining in patients who never developed (“No cGVHD”) or who develop cGVHD (“Yes cGVHD”). (F) Absolute CD3+ T cell number in patients who never developed (−) or developed (+) cGVHD, either treated with (+) steroids or never treated with (−) steroids. Reference BM (“No HSCT”) showed significantly more CD3+ T cells compared to the + or − cGVHD group after steroid therapy was excluded (*P = .04 and P < .01, respectively). Description of patient groups: −cGVHD (total n = 15): patients who never developed cGVHD including those who received steroid treatment for acute GVHD (aGVHD; n = 3) and patients who were not receiving steroid treatment at the time of BM biopsy (n = 12), followed for a total median of 792 and 980 days, respectively. +cGVHD (total n = 15): patients who developed GVHD (n = 15) receiving high-dose steroids (≥0.5 mg/kg; n = 9) vs those without steroid therapy from time of HSCT to time of BM biopsy (n = 6), followed for a total median of 630 and 1100 days, respectively. No HSCT (total n=11): Age and gender-matched reference biopsies from untreated patients with non-Hodgkin lymphoma (NHL; diffuse large B cell lymphoma [n = 7]; low-grade NHL [n = 2], follicular lymphoma, grade 3 [n = 1], classic Hodgkin lymphoma [n = 1]) who underwent staging BM evaluation. For all micrographs, the original magnification was 600×. Box and whisker plots express the median, 25th and 75th percentile at the ends of the box, and 5th and 95th percentile at the ends of the whiskers. Biology of Blood and Marrow Transplantation 2012 18, 968-973DOI: (10.1016/j.bbmt.2012.03.005) Copyright © 2012 American Society for Blood and Marrow Transplantation Terms and Conditions