Submitted January 25, 2008
Accepted April 18, 2008
Is allergic disease curable or transferable with allogeneic hematopoietic cell transplantation?
Faisal Khan, Teal S Hallstrand, Michelle N Geddes, William R Henderson Jr., and Jan Storek*
Dept of Medicine, University of Calgary, Calgary, AB, Canada
Dept of Medicine, University of Washington, Seattle, WA, United States
* Corresponding author; email: jstorek{at}ucalgary.ca.
In the pathogenesis of allergic disease, two main types of cells play a role: hematolymphatic cells (eosinophils, T cells, B cells) and nonhematolymphatic cells (airway smooth muscle cells, epithelial cells). It is not known which one of the two cell types plays the primary role. Here we review the literature on allergy transfer and cure with allogeneic hematopoietic cell transplantation (HCT), as transferability and curability would support the primary role of hematolymphatic cells, which would have implications for donor selection for HCT and possible future treatment of severe allergic disease with HCT. A total of 16 nonallergic recipients with allergic donors were reported to develop allergic disease posttransplant, however, conclusive information was available for only 5 cases. Allergic disease was reported to abate in 3 allergic recipients with nonallergic donors, however, conclusive information was available for only 2 cases. Problems in interpreting the reports include incomplete data on allergic disease in the donor or recipient pretransplant, not knowing the denominator, and the lack of controls. In summary, review of the literature generates the hypothesis that allergic disease is transferable and curable with HCT. A prospective study, including appropriate controls, is needed to evaluate this hypothesis.
