PMC10405622_01
Bone marrow morphology before (A, B) and after cord blood stem cell transplantation (C, D). Fig. 1 A and B depict bone marrow aspirate smears at the initial presentation with myeloblasts in a background of dysplastic erythroid and myeloid elements (Wright-Giemsa stains, photographed at 1000x). Fig. 1 C and D display photomicrographs of bone marrow aspirate smears after CB-SCT that are consistent with a complete remission and that depict scattered large granular lymphocytes (black arrows) in a background of mildly dysplastic myeloid cells, some with hypogranular cytoplasm (blue arrow).
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F1
The patient's bone marrow aspirate revealed 43% blasts with the morphology and an immunophenotype consistent with acute myeloid leukemia (AML), M4 according to the French-American-British (FAB) classification (see Fig. 1 A, B). Fig. 1 C and D show bone marrow aspirate smears after CB-SCT that are consistent with a complete remission and depict scattered large granular lymphocytes.
Expansion of autologous, CD8+ T cells after CB-SCT. Fig. 2A depicts the kinetics of the lymphocytosis after non-myeloablative conditioning with FC, ATG and TBI, and subsequent CB-SCT (indicated by the arrow). Fig. 2B illustrates the immunophenotype of the expanded T cells. Displayed are the forward (FSC) and sideward scatter (SSC) characteristics with gating on the lymphocyte population (left hand box), and staining with anti-CD3 and anti-CD8 mAbs, revealing that 83.3% of the lymphocytes were CD8 positive (center box). Staining with anti-CD57 and anti-CD94 mAbs (right hand box) also revealed that these CD8+ T cells displayed a phenotype consistent with large granular lymphocytes (LGL), which is in keeping with the morphology of these activated lymphocytes (Fig. 1C, D).
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F2
About 6-7 weeks after the CB-SCT, the patient gradually developed a lymphocytosis that is illustrated in Fig. 2A. Fig. 2B illustrates the immunophenotype of the expanded T cells.