FASTER IMMUNOLOGICAL RECOVERY AFTER BONE MARROW TRANSPLANTATION IN PATIENTS WITHOUT CYTOMEGALOVIRUS INFECTION

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Abstract
The following findings were noted among 45 bone marrow transplant recipients. The patients without cytomegalovirus (CMV) infection or chronic graft-vs.-host disease (GVHD) showed normal lymphocyte stimulation in vitro by concanavalin A (Con A) at > 3 mo. after transplantation, and normal stimulation by phytohemagglutinin (PHA), anti-.beta.2-microglobulin (A-.beta.2m) and protein A (SpA) after 6 mo. The patient who had CMV infection without chronic GVHD had Con A and SpA responses within the normal range after 12 mo. and reduced lymphocyte responses to PHA and A-.beta.2m at > 12 mo. after transplantation. The patients with chronic GVHD had reduced responses to all 4 mitogens after > 12 mo. In comparison with other patients, those who later developed chronic GVHD showed an increased mixed lymphocyte culture stimulation during the first 3 mo. that decreased between 6-12 mo. Patients with chronic GVHD still had reduced IgA levels at 12 mo. after transplantation. Patients with CMV infection, but without chronic GVHD, had higher percentages of lymphocytes with surface membrane Ig than healthy controls during the first 3 mo. after transplantation. The data suggest that CMV infection, regardless of chronic GVHD, delays immunologic recovery after marrow transplantation.