Immunological recovery after bone marrow transplantation: role of age, graft-versus-host disease, prednisolone treatment and infections.
Cellular immune recovery was studied in 67 patients who had survived for one month to more than 6 years after bone marrow transplantation (BMT). From a number of immunological parameters the mitogens phytohemagglutinin, concanavalin A and rabbit antibodies to beta 2 microglobulin (A-beta 2m) were chosen because of relevant increases in lymphocyte responses with time after BMT for analysis with exponential functions (covariance analysis). Patients with younger donors had a markedly higher lymphocyte response level and a faster rate of increase with time than patients with older donors. High recipient age was also significantly associated with a depressed level of immunological response but to a lesser degree than donor age. Patients with chronic graft-versus-host disease (GVHD) had a more severely impaired response compared to patients without chronic GVHD. Furthermore, patients with GVHD showed a negative development over time with the A-beta 2m test. Lymphocytes from patients receiving a low donor marrow cell dose showed impaired response levels and rate of recovery compared to the high-dose group although the differences were not significant. Patients treated with prednisolone for grade I GVHD had depressed lymphocyte stimulations for up to 1 1/2 years post BMT compared to patients without GVHD and not receiving prednisolone. Patients with non-viral infections seemed to have more depressed lymphocyte responses than non-infected patients. Patients undergoing cytomegalovirus infections had lower response levels for all three mitogens.
Paulin
T
T
Department of Clinical Immunology, Karolinska Institute, Stockholm, Sweden.
Ringdén
O
O
Nilsson
B
B
D000293:Adolescent; D000328:Adult; D000375:Aging; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects*; D007159:Immunologic Tests; D007223:Infant; D007239:Infections / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011239:Prednisolone / Q000627:therapeutic use*
D011239:Prednisolone