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 Blood, 15 November 2004, Vol. 104, No. 10, pp. 3086-3090.
Prepublished online as a Blood First Edition Paper on July 27, 2004; DOI 10.1182/blood-2004-05-1775.

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CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS

Long-term acquisition of allergen-specific IgE and asthma following allogeneic bone marrow transplantation from allergic donors

Teal S. Hallstrand, Jay D. Sprenger, Jan M. Agosti, Gary M. Longton, Robert P. Witherspoon, and William R. Henderson, Jr

From the Department of Medicine, University of Washington, Seattle, WA; and the Fred Hutchinson Cancer Research Center, Seattle, WA.

Adoptive transfer of allergen-specific immunoglobulin E (IgE) from atopic donors to nonatopic recipients occurs during the first year following bone marrow transplantation (BMT). Mature B- and T-cell clones with allergen-specific memory and hematopoietic progenitor cells are transferred through BMT. The objective of this study was to characterize the long-term rate of allergic sensitization and development of clinical allergic diseases following BMT from atopic donors. A long-term follow-up study was conducted in a cohort of donor and recipient pairs with moderate-to-severe allergic disease in the donor prior to BMT. Assessments of allergen-specific IgE, clinical rhinitis, and asthma were made in the donors prior to BMT and in the recipients with a mean follow-up of 15.5 years after BMT. From an initial cohort of 12 bone marrow transplant recipients who received marrow from allergic donors, 5 long-term survivors were identified. Allergen-specific IgE transferred from donor to recipient following BMT frequently persisted, and a high rate of de novo allergic sensitization was observed between 1 and 14 years after BMT. These events were associated with elevation in total IgE, and development of allergic rhinitis and asthma at long-term follow-up. We conclude that marrow-derived immune cells from allergic donors can transfer the predisposition to allergy and asthma.


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