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Prepublished online as a Blood First Edition Paper on December 27, 2002; DOI 10.1182/blood-2002-05-1376.
Submitted May 10, 2002
Accepted December 2, 2002
Factors affecting antibody levels after allogeneic hematopoietic cell transplantation
Jan Storek*, Federico Viganego, Monja A Dawson, M M Herremans, Michael Boeckh, Mary E Flowers, Barry Storer, William I Bensinger, Robert P Witherspoon, and David G Maloney
Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA, USA
National Institute of Public Health and Environment, Bilthoven, The Netherlands
* Corresponding author; email: jstorek{at}fhcrc.org.
To obtain insight into the mechanism(s) of posttransplant 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 ~10-times more lymphocytes than marrow. Blood stem cell recipients did not have higher antibody levels than marrow recipients. Recipient pretransplant antibody levels were correlated with the posttransplant levels, especially in the first 6 months posttransplant when the correlation coefficients typically exceeded 0.6. Donor pretransplant antibody levels had less of a correlation with posttransplant 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 transplant are affected primarily by pretransplant antibody levels in the recipient and, to a lesser degree, in the donor. These findings suggest that immunization of the recipient and the donor pretransplant may be more effective in improving antibody immunity posttransplant than manipulating graft-versus-host disease, changing conditioning or increasing the number of lymphocytes in the graft.
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