IMMUNE RECOVERY FOLLOWING ALLOGENEIC BONE MARROW TRANSPLANTATION

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Abstract
A total of 144 evaluations of cells surface markers and cellular immune functions were carried out in 57 patients undergoing allogeneic bone marrow transplantation for acute leukemia in remission and relapse and for aplastic anemia. The periods tested were pretransplant, and 1-3, 4-6, 7-12 and more than 12 mo. posttransplant. The determination consisted of lymphocyte counts; lymphocyte surface marking using OKT3, OKT4 and OKT8 antibodies; and determination of adherent cells, lysozymes and antibody dependent cellular cytotoxicity (ADCC) against chicken red blood cells, human red blood cells and CEM [T cell leukemia] cells. Natural killer cells were determined against K562 target cells. Lymphoblastic responses were tested after stimulation with pokeweed mitogen (PWM), concanavalin-A (Con-A) and phytohemagglutinin (PHA). The progression in the leukemic state (1st remission, 2nd remission and relapse), prior to transplantation was paralleled by a decrease in T4 lymphocytes (976/.mu.1 .+-. 462; 411/.mu. .+-. 222;372/.mu.1 .+-. 419; P = 0.04). There was a lack of helper cells and an inverted T4:T8 ratio beyond 1 yr posttransplant independent of graft-vs.-host disease status. Lymphocyte functions were depressed for > 1 yr. There was a direct correlation of T4 helper cells and an inverse correlation of T8 suppressor cells with lymphoblastic responses to migotens. The longitudinal evaluations of immune functions after allogeneic bone marrow transplantation and the characterization of the immune defects seen may lead to better immunorestorative treatments.