Bone marrow transplantation in combined immunodeficiencies.
Correction of combined immunodeficiences was attempted in 4 patients. Attainment of lasting immunologic reconstitution was restricted to an HL-A identical graft. However, HL-A identity was not a safeguard against graft-vs-host reaction (GVHR). Failure of donor-host adaptation resulted in chronic GVHR. In unmatched grafts, alloimmune plasma was capable of only transient amelioration of GVHR. Alloimmune plasma prevented fatal GVHR in one patient receiving a HL-A semiidentical graft. However, no direct evidence for a T-cell engraftment was shown. The failure to prevent GVHR or to reverse an ongoing reaction in incompatible bone marrow transplantations demands a reappraisal of the conceptual approach to immunologic tolerance.
D000017:ABO Blood-Group System; D000946:Antigens, Fungal; D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation; D002175:Candida / Q000276:immunology; D002177:Candidiasis / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005856:Germ-Free Life; D006087:Graft vs Host Reaction; D006648:Histocompatibility; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000235:genetics / Q000628:therapy*; D007223:Infant; D008213:Lymphocyte Activation; D007959:Lymphocyte Culture Test, Mixed; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D010375:Pedigree; D010950:Plasma Cells / Q000276:immunology; D012882:Skin Tests; D013936:Thymidine / Q000378:metabolism; D014184:Transplantation, Homologous; D014316:Tritium
D000017:ABO Blood-Group System; D000946:Antigens, Fungal; D014316:Tritium; D013936:Thymidine