Passive donor-to-recipient transfer of antiphospholipid syndrome following allogeneic stem-cell transplantation.
Autoantibody production following allogeneic stem-cell transplantation is common and is often ascribed to the immune dysregulation associated with graft-versus-host disease. Recent data suggests that donor-memory B cells can be reactivated on exposure to antigen and result in antibody production in the recipient identical to that seen in the donor. Here we describe the production of autoantibodies in a recipient of bone marrow from a donor with systemic lupus erythematosus and antiphospholipid syndrome. Autoantibody appearance was precipitated by the onset of graft-versus-host disease, was identical to that of the donor, and ultimately lead to cerebrovascular thrombosis, which was successfully treated with antiplatelet and anticoagulant therapy.
Ritchie
D S
DS
Malaghan Institute of Medical Research, Wellington, New Zealand. dritchie@malaghan.org.nz
Sainani
A
A
D'Souza
A
A
Grigg
A P
AP
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000209:etiology* / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology; D016026:Bone Marrow Transplantation / Q000276:immunology; D006086:Graft vs Host Disease / Q000276:immunology*; D006801:Humans; D007156:Immunologic Memory; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D014019:Tissue Donors; D014184:Transplantation, Homologous
D001323:Autoantibodies