The Immunodeficiency of Bone Marrow-Transplanted Patients.

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Abstract
Lymphocytes from patients after bone marrow transplantation (BMT) are in most cases predominantly of the Leu‐2+ (cytotoxic/suppressor) phenotypes and are almost unresponsive to mitogens. In contrast, normal Leu‐3+‐depleted, Leu‐2+‐enriched lymphocyte suspensions retain approximately 50% of the mitogenic response compared with that of unseparated cells. To investigate whether this discrepancy was due to active suppression, we selected nine BMT patients from whom sufficient numbers of cells were available and whose lymphocyte phenotypes were predominantly Leu‐2+ after BMT. These post‐BMT lymphocytes were tested for functional suppressor activities against donor and recipient pre‐BMT lymphocytes in the lymphocyte transformation test. None of these post‐BMT cells suppressed the response of donor or pre‐BMT cells to phytohaemagglutinin A or concanavalin A. In contrast, the response of donor cells in mixed lymphocyte cultures to HLA‐DR‐different third‐party cells was suppressed by highly X‐irradiated post‐BMT cells by approximately 40%. Addition of T‐cell growth factor (=interleukin 2 (IL‐2)) or X‐irradiated donor cells to post‐BMT lymphocytes partially restored the mitogenic respose. These findings indicate that the early post‐BMT cells lack production of IL‐2 but are capable of responding to IL‐2 and that the almost extinct mitogen response of these cells is due to immaturity rather than active suppression. The suppression of the allogeneic but not the mitogenic response might be explained by differences in the modes of activation; for example, the allogeneic response must involve the T‐cell receptor, while the mitogenic response may not.