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Long lasting IgG subclass and antibacterial polysaccharide antibody
deficiency after allogeneic bone marrow transplantation
P Aucouturier, A Barra, L Intrator, C Cordonnier, D Schulz, F Duarte, JP Vernant and JL Preud'homme
Serum IgG subclasses were measured by a competitive indirect immunoassay
with monoclonal antibodies in 31 leukemic patients before and after bone
marrow transplantation. Antibodies to Hemophilus influenzae type b (Hib)
capsular polysaccharide were determined in 28 cases. Abnormally low or
borderline subclass (mostly IgG2 and IgG4) levels were found late after
transplant in 23 infected and noninfected patients. These levels persisted
for as long as 25 months, in association with low or borderline IgA levels
in 78% of the cases. IgG2, IgG4, and IgA often showed a parallel evolution,
whereas IgG1, IgG3, and IgM often varied together in the opposite way.
Class but not subclass deficiencies were more frequent in patients with
graft-v-host disease (GVHD). Subclass abnormalities predominated in
infected patients, with mean levels correlating with the severity of
infections; however, the abnormalities are not clearly predictive of
infections in individual cases. Most patients with Hib pneumonia showed
virtually no IgG antibody response to Hib, and one-half of the patients had
a moderate IgM and IgA response. In the whole series, many sera collected
greater than 1 year after graft contained very low or undetectable
antibodies. Correlation between anti-Hib antibody and IgG2 levels was
significant but weak because of discrepancies that were only partially
explained by the subclass distribution of the antibodies.
Volume 70,
Issue 3,
pp. 779-785,
09/01/1987
Copyright © 1987 by The American Society of Hematology
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