Factors affecting antibody levels after allogeneic hematopoietic cell transplantation

• Published in: Blood Vol. 101; no. 8; pp. 3319 - 3324
• Main Authors: Storek, Jan, Viganego, Federico, Dawson, Monja A., Herremans, M. M. P. Tineke, Boeckh, Michael, Flowers, Mary E.D., Storer, Barry, Bensinger, William I., Witherspoon, Robert P., Maloney, David G.
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 15-04-2003; The Americain Society of Hematology
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antibody Formation - radiation effects; Antibody Specificity; Antigens, Bacterial - immunology; Antigens, Viral - immunology; Biological and medical sciences; Bone Marrow Transplantation - immunology; Bone marrow, stem cells transplantation. Graft versus host reaction; Female; Follow-Up Studies; Graft vs Host Disease - immunology; Humans; Immunoglobulin G - blood; Immunologic Memory; Immunosuppression - adverse effects; Male; Medical sciences; Middle Aged; Peripheral Blood Stem Cell Transplantation; Randomized Controlled Trials as Topic; Tissue Donors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation Conditioning; Transplantation, Homologous - immunology; Whole-Body Irradiation - adverse effects; Human; Immunization; Total body irradiation; Immune response; Antibody; Stem cell; Hematopoietic cell; Homograft; Immune reconstitution; Recipient; Blood cell; Donor; Host versus graft disease; Bone marrow; Graft; Age; Comparative study; Humoral immunity
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2002-05-1376

To obtain insight into the mechanism(s) of posttransplantation humoral immunodeficiency, we evaluated factors affecting serum antibody levels against polio, tetanus,Haemophilus influenzae,andStreptococcus pneumoniaein 87 patients. Patients with hematologic malignancies were randomized to receive marrow versus blood stem cells, which contain approximately 10 times more lymphocytes than marrow. Blood stem cell recipients did not have higher antibody levels than marrow recipients. Recipient pretransplantation antibody levels were correlated with the posttransplantation levels, especially in the first 6 months after transplantation when the correlation coefficients typically exceeded 0.6. Donor pretransplantation antibody levels had less of a correlation with posttransplantation levels in the recipient. Patient or donor age, total body irradiation, and graft-versus-host disease or its treatment appeared to have no effect. In conclusion, antibody levels in the first year after transplantation are affected primarily by pretransplantation antibody levels in the recipient and, to a lesser degree, in the donor. These findings suggest that immunization of the recipient and the donor before transplantation may be more effective in improving antibody immunity after transplantation than manipulating graft-versus-host disease, changing conditioning, or increasing the number of lymphocytes in the graft.