Induction of graft-versus-host disease after autologous bone marrow transplantation.
To induce graft-versus-host disease (GvHD) in patients undergoing autologous bone marrow transplantation (BMT), five consecutive patients with non-Hodgkin lymphoma or Hodgkin's disease in resistant relapse were treated with cyclophosphamide and total body irradiation or busulphan and cyclophosphamide, followed by autologous BMT. The patients received cyclosporin 1 mg/kg per day intravenously for 28 days after BMT. Histologically proven grade II acute GvHD of the skin developed in all the patients at a median of 11 days (range 9-13) after BMT. One patient died and the GvHD resolved in 1-3 weeks in the four remaining patients--spontaneously in two and with corticosteroid treatment in two. Lymphocytes from one patient obtained at the time of GvHD were cytotoxic for the patient's own pretransplant lymphocytes. Cytotoxicity was blocked by antibodies directed against class II histocompatibility (HLA-DR or Ia) antigens. Cyclosporin-induced GvHD after autologous BMT resembles mild GvHD after allogeneic grafting. This syndrome appears to be mediated by autoreactive Ia-specific lymphocytes.
Jones
R J
RJ
Johns Hopkins Oncology Center, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205.
Vogelsang
G B
GB
Hess
A D
AD
Farmer
E R
ER
Mann
R B
RB
Geller
R B
RB
Piantadosi
S
S
Santos
G W
GW
D000208:Acute Disease; D000328:Adult; D001327:Autoimmune Diseases / Q000139:chemically induced*; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D003524:Cyclosporins / Q000009:adverse effects*; D005260:Female; D006086:Graft vs Host Disease / Q000139:chemically induced* / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006689:Hodgkin Disease / Q000276:immunology / Q000628:therapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000139:chemically induced* / Q000276:immunology; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D014182:Transplantation, Autologous
D003524:Cyclosporins; D000949:Histocompatibility Antigens Class II