HTLV-III infection after bone marrow transplantation
JH Antin, BR Smith, BM Ewenstein, RJ Arceci, JM Lipton, PL Page and JM Rappeport
We prospectively documented the development of a fatal, secondarily
acquired severe immunodeficiency in a 19-year-old man who underwent
uncomplicated bone marrow transplantation. He had no graft v host disease
(GVHD) and had normal recovery of his immune system as determined by
lymphocyte phenotyping, mitogenic responses of his peripheral blood
lymphocytes, and his ability to secrete immunoglobulin. This alteration in
immunity was associated with the acquisition of antibody to HTLV-III. His
only risk factor for the development of HTLV-III infection was the
transfusions he had received during the transplant and recovery period. Two
of his 54 transfusions were from an asymptomatic individual at high risk
for acquired immunodeficiency syndrome (AIDS), who was subsequently found
to be seropositive for anti-HTLV-III and from whom HTLV-III was isolated.
The loss of immunocompetence in patients without chronic GVHD disease is
unusual, and our data support the view that this patient's immunodeficiency
was due to HTLV-III. When bone marrow transplant recipients without chronic
GVHD develop late opportunistic infections, consideration should be given
to transfusion-associated AIDS.
Volume 67,
Issue 1,
pp. 160-163,
01/01/1986
Copyright © 1986 by The American Society of Hematology
