Rejection of bone-marrow graft by recipient-derived cytotoxic T lymphocytes against minor histocompatibility antigens.
A female patient showed rejection of a T-lymphocyte-depleted bone-marrow graft from her phenotypically HLA-identical father. Before bone-marrow transplantation, there was strong recipient anti-donor cellular cytotoxic reactivity directed against several minor histocompatibility (mH) antigens, including the male-specific H-Y antigen. After conditioning treatment, no recipient anti-donor cytotoxic activity could be detected, and good graft function was shown a month after transplantation. Thereafter, however, graft function deteriorated rapidly, while recipient-derived anti-donor cellular cytotoxic reactivity, against similar mH antigens, reappeared. The recipient-derived cytotoxic T lymphocytes could completely inhibit growth of donor haemopoietic progenitor cells both before and after bone-marrow transplantation. Thus, cytotoxic T lymphocytes can survive very intensive conditioning regimens, and residual recipient cytotoxic T lymphocytes directed against mH antigens expressed on donor haemopoietic progenitor cells may cause graft rejection after HLA-identical T-lymphocyte-depleted bone-marrow transplantation.
Voogt
P J
PJ
Department of Haematology, University Hospital, Leiden, Netherlands.
Fibbe
W E
WE
Marijt
W A
WA
Goulmy
E
E
Veenhof
W F
WF
Hamilton
M
M
Brand
A
A
Zwann
F E
FE
Willemze
R
R
van Rood
J J
JJ
D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D002460:Cell Line; D002874:Chromosome Mapping; D005069:Evaluation Studies as Topic; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006182:H-Y Antigen / Q000032:analysis; D006680:HLA Antigens / Q000276:immunology*; D006412:Hematopoietic Stem Cells / Q000276:immunology; D006801:Humans; D008212:Lymphocyte Depletion; D008297:Male; D008677:Metaphase; D009190:Myelodysplastic Syndromes / Q000601:surgery*; D010641:Phenotype; D013602:T-Lymphocytes, Cytotoxic / Q000166:cytology / Q000502:physiology*; D013997:Time Factors; D014181:Transplantation Immunology
D006182:H-Y Antigen; D006680:HLA Antigens