> 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
