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Analysis of late infections after human bone marrow transplantation: role
of genotypic nonidentity between marrow donor and recipient and of
nonspecific suppressor cells in patients with chronic graft-versus-host
disease
K Atkinson, V Farewell, R Storb, MS Tsoi, KM Sullivan, RP Witherspoon, A Fefer, R Clift, B Goodell and ED Thomas
Infections occurring 6 mo or later after bone marrow transplantation for
severe aplastic anemia or hematologic malignancy were analyzed in 98
long-term survivors. Varicella-zoster (VZ) infections were analyzed
separately from all other infections. The factor predisposing most strongly
to late VZ infection was genotypic nonidentity for HLA between marrow donor
and recipient. There was a suggestion that chronic graft- versus-host
disease (GVHD) associated with the presence of nonspecific suppressor cells
also predisposed to late VZ infection, while age less than 10 yr was
protective against such infections. Chronic GVHD predisposed to late non-VZ
infections, but this was not increased by the presence of nonspecific
suppressor cells. HLA nonidentify between patient and marrow donor further
increased the risk of late non-VZ infections over and above that due to the
presence of chronic GVHD. Receipt of a syngeneic transplant appeared
protective for late non-VZ infections. These findings suggest that full
genotypic identity for HLA between donor and recipient may be required for
optimal immune reconstitution after marrow transplantation and may denote a
possible biologic role for nonspecific suppressor T cells in humans.
Volume 60,
Issue 3,
pp. 714-720,
09/01/1982
Copyright © 1982 by The American Society of Hematology
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