Idiopathic CD4+ T lymphocytopenia is associated with increases in immature/transitional B cells and serum levels of IL-7

Transient bone marrow lymphoproliferation after umbilical cord blood transplantation: Exacerbated reconstitution of B‐cell ontogeny in adults

“…In our cases, the isolated bone marrow involvement and the maturation continuum stated by means of flow cytometry on the one hand and the negativity of EBV testing on the other hand did not support an EBV-related PTLD and caused us to suspect a physiologic, immune reconstitution-related nature of the process. We further supported our differential diagnosis based on the exacerbated B-cell physiologic expansions reported in the setting of T cell depleted patients with primary immunodeficiencies and AIDS [3]. Regarding the abnormal PCR clonality assays, several scenarios have been shown in which gene rearrangements may be detected in non-neoplastic conditions, such as autoimmune disorders or infectious diseases [4].…”

“…PCR study for immunoglobulin heavy chain rearrangement showed a clonal pattern. As in patient 1, a profound defect in T immune reconstitution was noted with a barely detectable total CD31 cell count, not exceeding five per mm 3 .…”

“…No lymphadenopathy or hepatosplenomegaly were demonstrated by computer tomography (CT) scan, and Epstein Barr Virus (EBV) serologic tests and quantitative PCR for EBV-DNA on bone marrow specimens were negative. Persistent full donor chimerism was noted, together with a profound defect in T immune reconstitution with total CD31 cell counts not exceeding one per mm 3 . No specific treatment was initiated.…”

“…Accessory splenectomy for refractory immune thrombocytopenic purpura Gita Thanarajasingam, 1 Rakhee Vaidya, 2 Andrew Erie, 3 and Alexandra P. Wolanskyj 4 * Patients with immune thrombocytopenic purpura (ITP) will frequently relapse following splenectomy. The removal of residual spleens remains a therapeutic option in these patients though the effectiveness of this procedure remains unclear.…”

CXCR4, une cible thérapeutique dans certains déficits immunitaires rares?

“…Sur un plan immunologique, les LT CD4 + naïfs sont préférentiellement affectés dans le sang, alors que le nombre de LT CD8 + est préservé ou parfois diminué, constituant alors un facteur aggravant [8]. Une altération fréquente consiste en une augmentation sérique d'interleukine-7 (IL-7), compatible avec le déclenchement d'une réponse homéostatique qui vise à reconstituer le taux de LT CD4 + [9]. Des études rapportent une diminution des réponses des LT, une augmentation de leur activation et une capacité accrue à entrer en apoptose [10].…”