Immunological recovery after bone marrow transplantation: role of age, graft-versus-host disease, prednisolone treatment and infections

Bone Marrow Transplant. 1987 Feb;1(3):317-28.

Abstract

Cellular immune recovery was studied in 67 patients who had survived for one month to more than 6 years after bone marrow transplantation (BMT). From a number of immunological parameters the mitogens phytohemagglutinin, concanavalin A and rabbit antibodies to beta 2 microglobulin (A-beta 2m) were chosen because of relevant increases in lymphocyte responses with time after BMT for analysis with exponential functions (covariance analysis). Patients with younger donors had a markedly higher lymphocyte response level and a faster rate of increase with time than patients with older donors. High recipient age was also significantly associated with a depressed level of immunological response but to a lesser degree than donor age. Patients with chronic graft-versus-host disease (GVHD) had a more severely impaired response compared to patients without chronic GVHD. Furthermore, patients with GVHD showed a negative development over time with the A-beta 2m test. Lymphocytes from patients receiving a low donor marrow cell dose showed impaired response levels and rate of recovery compared to the high-dose group although the differences were not significant. Patients treated with prednisolone for grade I GVHD had depressed lymphocyte stimulations for up to 1 1/2 years post BMT compared to patients without GVHD and not receiving prednisolone. Patients with non-viral infections seemed to have more depressed lymphocyte responses than non-infected patients. Patients undergoing cytomegalovirus infections had lower response levels for all three mitogens.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aging*
  • Bone Marrow Transplantation*
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Immunologic
  • Female
  • Graft Survival
  • Graft vs Host Disease / drug therapy
  • Graft vs Host Disease / immunology*
  • Graft vs Host Disease / physiopathology
  • Humans
  • Immunity, Cellular / drug effects*
  • Immunologic Tests
  • Infant
  • Infections / etiology
  • Infections / immunology*
  • Infections / physiopathology
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Prednisolone / therapeutic use*

Substances

  • Prednisolone