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Prepublished online as a Blood First Edition Paper on December 27, 2002; DOI 10.1182/blood-2002-05-1376.
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Blood, 15 April 2003, Vol. 101, No. 8, pp. 3319-3324
TRANSPLANTATION
Factors affecting antibody levels after allogeneic
hematopoietic cell transplantation
Jan Storek,
Federico Viganego,
Monja A. Dawson,
M. M. P. Tineke Herremans,
Michael Boeckh,
Mary E. D. Flowers,
Barry Storer,
William I. Bensinger,
Robert P. Witherspoon, and
David G. Maloney
From the Fred Hutchinson Cancer Research Center
(FHCRC), Seattle, WA; University of Washington, Seattle, WA;
and the National Institute of Public Health and Environment, Bilthoven,
the Netherlands.
To obtain insight into the mechanism(s) of posttransplantation
humoral immunodeficiency, we evaluated factors affecting serum antibody
levels against polio, tetanus, Haemophilus influenzae, and
Streptococcus pneumoniae in 87 patients. Patients with
hematologic malignancies were randomized to receive marrow versus blood
stem cells, which contain approximately 10 times more lymphocytes than marrow. Blood stem cell recipients did not have higher antibody levels
than marrow recipients. Recipient pretransplantation antibody levels
were correlated with the posttransplantation levels, especially in the
first 6 months after transplantation when the correlation coefficients
typically exceeded 0.6. Donor pretransplantation antibody levels had
less of a correlation with posttransplantation levels in the recipient.
Patient or donor age, total body irradiation, and graft-versus-host
disease or its treatment appeared to have no effect. In conclusion,
antibody levels in the first year after transplantation are affected
primarily by pretransplantation antibody levels in the recipient and,
to a lesser degree, in the donor. These findings suggest that
immunization of the recipient and the donor before transplantation may
be more effective in improving antibody immunity after transplantation
than manipulating graft-versus-host disease, changing conditioning, or
increasing the number of lymphocytes in the graft.

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