LYMPHOCYTOTOXIC ANTIBODIES AFTER BONE MARROW TRANSPLANTATION IN APLASTIC ANEMIA

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Abstract
Forty-seven recipients with aplastic anemia who received a bone marrow transplant (BMT) from an HLA-identical sibling have been studied. Sera were analyzed after platelet absorption, and they were tested on target cells from a panel of unrelated donors, from the recipient, and his family. Sixty-two percent of the patients displayed lymphocytotoxins (LTs) that were directed to non-HLA antigens, and that reacted with B and/or T lymphocyte subpopulations. These LTs were temperature sensitive with maximum activity detectable at 20 or 15 C, exceptionally at 37 C. In 16 patients, LTs reacted with the recipients' as with other allogeneic cells and they were referred to as autoantibodies, while in 13 cases they were only alloantibodies. When auto-LTs reacted against both B and T lymphocytes, the percentage of killing on the B cell panel was usually larger than that on the T cell panel, which suggests that the membrane determinants involved are present at a higher density on B cells and at a lower density on T cells or that, at least in some instances, LTs do not recognize the same specificities on B and T cells. However absorption on either T or B lymphocytes completely removed reactivity to both of these cell populations. No statistically significant correlation could be found between the presence of auto- or allo- LTs, either before or after BMT, and the clinical evolution. However, different patterns of antibody production were noted in relation to graft outcome:LTs appeared during the 2nd or 3rd month and were transient in the patients with graft take, they occurred earlier on and persisted in case of graft-versus-host disease (GVHD), and they appeared during rejection and waned once the rejection process was completed.

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