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Graft versus graft and graft versus host reactions after HLA‐identical bone marrow transplantation in a patient with severe combined immunodeficiency with transplacentally acquired lymphoid chimerism

Publication ,  Journal Article
Friedman, NJ; Shiff, SE; Ward, FE; Schiff, RI; Buckley, RH
Published in: Pediatric Allergy and Immunology
January 1, 1991

We describe a patient with severe combined immunodeficiency and transplacental transfer of maternal T cells who received an unfractionated HLA‐identical sibling bone marrow transplant without prior conditioning. He presented prior to transplantation with a dermatitis later diagnosed as mild graft versus host disease. He had a normal absolute lymphocyte count, but proliferative responses to mitogens were very low. Antigens of the noninherited maternal HLA haplotype were detected on his blood lymphocytes. After transplantation, he developed a severe reaction including fever, cutaneous erythema and hepatosplenomegaly. Lymphocytes carrying the noninherited maternal HLA haplotype disappeared from his circulation, and his unprimed mononuclear cells became spontaneously cytotoxic to maternal lymphoblasts. He subsequently developed a lymphocytosis of 69,000/mm3, diarrhea, elevated transaminases and a worsening rash, necessitating treatment with immunosuppressive agents. Full T‐cell engraftment and evidence of B‐cell function later ensued and spontaneously cytotoxic lymphocytes against maternal cells disappeared by 47 days post‐transplantation. We postulate that the patient's constellation of signs and symptoms after transplantation represented a combination of severe graft versus graft and mild graft versus host reactions. Copyright © 1991, Wiley Blackwell. All rights reserved

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Published In

Pediatric Allergy and Immunology

DOI

EISSN

1399-3038

ISSN

0905-6157

Publication Date

January 1, 1991

Volume

2

Issue

3

Start / End Page

111 / 116

Related Subject Headings

  • Allergy
  • 1117 Public Health and Health Services
  • 1114 Paediatrics and Reproductive Medicine
  • 1107 Immunology
 

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Friedman, N. J., Shiff, S. E., Ward, F. E., Schiff, R. I., & Buckley, R. H. (1991). Graft versus graft and graft versus host reactions after HLA‐identical bone marrow transplantation in a patient with severe combined immunodeficiency with transplacentally acquired lymphoid chimerism. Pediatric Allergy and Immunology, 2(3), 111–116. https://doi.org/10.1111/j.1399-3038.1991.tb00192.x
Friedman, N. J., S. E. Shiff, F. E. Ward, R. I. Schiff, and R. H. Buckley. “Graft versus graft and graft versus host reactions after HLA‐identical bone marrow transplantation in a patient with severe combined immunodeficiency with transplacentally acquired lymphoid chimerism.” Pediatric Allergy and Immunology 2, no. 3 (January 1, 1991): 111–16. https://doi.org/10.1111/j.1399-3038.1991.tb00192.x.
Friedman, N. J., et al. “Graft versus graft and graft versus host reactions after HLA‐identical bone marrow transplantation in a patient with severe combined immunodeficiency with transplacentally acquired lymphoid chimerism.” Pediatric Allergy and Immunology, vol. 2, no. 3, Jan. 1991, pp. 111–16. Scopus, doi:10.1111/j.1399-3038.1991.tb00192.x.
Journal cover image

Published In

Pediatric Allergy and Immunology

DOI

EISSN

1399-3038

ISSN

0905-6157

Publication Date

January 1, 1991

Volume

2

Issue

3

Start / End Page

111 / 116

Related Subject Headings

  • Allergy
  • 1117 Public Health and Health Services
  • 1114 Paediatrics and Reproductive Medicine
  • 1107 Immunology