Bone Marrow transplant patient immunity questions

Frederick Garbrecht FRED at bmt.mcw.edu
Thu Nov 10 10:04:03 EST 1994


> To:            immunology at net.bio.net
> From:          jasmith at usuhsb.usuhs.mil
> Subject:       Bone Marrow transplant patient immunity questions
> Date:          Thu, 10 Nov 94 06:58:16 -500

> When BMT pts have recovered, how much of their original repertoire of 
> ag-specific T-cells, antibodies, etc are regained?  Do they lose immunity
> to common antigens, ie, rubella, mumps, viruses, etc?  If so, can they be
> reimmunized, given they are immunosuppressed (at least, the allogeneic
> transplant recipients)?  And how about surveillance cells, ie, NK, LAK, etc?
> Sorry for so many questions, but have found no definitive literature.  
> 
> 
Recovery of original repertoire probably depends mostly on how the 
patient was prepared for transplant.  In patients who have received 
total body irradiation and high dose chemotherapy, we think that 
virtually all antigen reactive lymphocytes are destroyed, so that 
virturally none of the original repertoire is retained.  Patients are 
subsequently re-immunized (usually successfully), but only after a 
fairly long time after transplant (often between 1 and 2 or more 
years).  At this time, most patients will be off immunosuppression.  
Interestingly, the surveillance cells (at least NK) do recover very 
quickly; in fact, within the lymphocyte compartment, NK cells are 
frequently the first group of cells to appear (within 2 to 3 weeks).

Frederick C. Garbrecht
fred at bmt.mcw.edu
Bone Marrow Transplant Program
Medical College of Wisconsin
phone 414 257 5053
fax   414 257 7994



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