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Background: Relapse of immune-related pancytopenia (IRP) has often occurred and is very difficult to cure; the pathogenesis of relapsed IRP was unclear. The aim of this work is to investigate whether memory B lymphocytes (Bm) in bone marrow were involved in pathogenesis of relapsed IRP.
Methods: Seventy-nine patients with IRP (26 untreated, 32 relapsed, and 21 remittent after relapsed) were assessed, the category and the titer of autoantibodies on bone marrow mononuclear cell (BMMNC-Ab), Bm (CD19+CD27+) cells, and activated Bm (CD19+CD27+HLA-DR+) cells in bone marrow were detected by fluorescence-activated cell sorting (FACS).
Results: The percentages of Bm cells (CD19+CD27+/CD19+) and activated Bm cells (CD19+CD27+HLA-DR+/ CD19+CD27+) were 34.73 ± 11.93% and 69.46 ± 25.22%, respectively, which were significantly higher than those of untreated IRP (4.73 ± 0.85%, 12.47 ± 8.29%) and remittent after relapsed IRP (1.32 ± 3.52%, 4.35 ± 6.61%) correspondingly (p < 0.05). The majority of BMMNC-Ab in relapsed patients were IgG (75%), and the positive rates and the titers of IgG autoantibody of relapsed IRP were significantly more elevated than those of untreated IRP (p < 0.05). The positive rate of IgM autoantibody in patients with untreated IRP was 69.23%, and the titer was 28.38 ± 28.00%, but no significant differences were found in the positive rate and titers of IgM between untreated IRP and relapsed IRP (p > 0.05).
Conclusions: In patients with relapsed IRP, Bm cells in bone marrow were increased and hyperactive. The predominant autoantibody was IgG. These findings suggest that autoreactive Bm cells may be involved in the pathogenesis of relapsed IRP.
DOI: 10.7754/Clin.Lab.2013.130220
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