DYSPLASTIC HEMATOPOIESIS FOLLOWING ORTHOTOPIC LIVER-TRANSPLANTATION -COMPARISON WITH SIMILAR CHANGES IN HIV-INFECTION AND PRIMARY MYELODYSPLASIA

To validate scientifically our prior empiric observations that patient s develop significant haemopoietic dysplasia following solid organ tra nsplantation we developed a quantitative lineage-specific scoring syst em to evaluate dysplastic features of bone marrow aspirates and core b iopsies. We used this scoring system to compare retrospectively random ly selected bone marrow aspirates and core biopsies from 19 patients u ndergoing orthotopic liver transplantation (OLT), 21 with a known hist ory of human immunodeficiency virus (HIV) infection, and 18 with prima ry or chemotherapy-related myelodysplastic syndromes (MDS). Our result s show that the OLT patient group developed significant but milder hae mopoietic dysplastic changes than the HIV or MDS groups, and that the MDS group developed more severe dysplasia of the myeloid lineage than the other groups. The possible roles for drugs and infectious agents i n the pathophysiology of dysplastic changes are discussed.