Anti-B-cell monoclonal antibody-purged autologous bone marrow transplantation for B-cell non-Hodgkin's lymphoma: phenotypic reconstitution and B-cell function

Blood. 1989 Nov 1;74(6):2203-11.

Abstract

In the present report we have attempted to examine immunologic reconstitution following high-dose chemoradiotherapy and anti-B-cell monoclonal antibody (MoAb)-purged autologous bone marrow transplantation (ABMT). By cell-surface phenotypic analysis, the majority of patients had normal percentage of natural killer cells (NK), monocytes, and CD8+ T cells at one month post-ABMT. In contrast, the percentage of CD4+ T cells was reduced for at least 3 years, and the CD4:CD8 ratio reflected this imbalance. B-cell reconstitution was slightly prolonged, with normal percentage and absolute numbers of CD20+ B cells evident by 3 months. Although B cells returned by 3 months, in vitro assessment of B-cell function demonstrated impairment of proliferative responses to either anti-immunoglobulins bound to beads (anti-Ig), Epstein-Barr virus (EBV), or interleukin-2 (IL-2) for approximately 1 year and low molecular B-cell growth factor (BCGF) for approximately 2 or more years. Moreover, in vivo B-cell reconstitution demonstrated a more selective defect, with normal levels of immunoglobulin IgM returning at 6 months, IgG at 12 months, and IgA after 2 years. Despite normal numbers of B cells and relative normal levels of Ig early following ABMT, our in vitro data suggest an intrinsic defect in B-cell responsiveness. Moreover, these defects are similar to those observed following nonpurged autologous and allogeneic BMT, although the interval of immune impairment appears more prolonged.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antigens, CD / analysis
  • Antigens, CD20
  • Antigens, Differentiation, B-Lymphocyte
  • B-Lymphocytes / immunology*
  • Bone Marrow Transplantation / immunology*
  • Immunoglobulins / metabolism
  • Interleukin-4 / pharmacology
  • Lymphocyte Activation
  • Lymphoma, Non-Hodgkin / surgery*
  • Receptors, Antigen, B-Cell / physiology
  • Time Factors
  • Transplantation, Autologous

Substances

  • Antibodies, Monoclonal
  • Antigens, CD
  • Antigens, CD20
  • Antigens, Differentiation, B-Lymphocyte
  • Immunoglobulins
  • Receptors, Antigen, B-Cell
  • Interleukin-4