Development of allergy post‐bone marrow transplantation

Gennery, AR; Cant, AJ

doi:10.1046/j.1365-2222.2002.01565.x

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…Although 2 recent case reports 27,28 suggest that allergic disease may be a consequence of immune dysregulation following BMT, there is no widespread evidence of increased allergic disease in BMT recipients at the high rate demonstrated in this study. 29 Second, elevation in total IgE is known to occur following BMT; however, this appears to be a transient phenomenon that occurs early after BMT without long-term persistence. 30,31 Other diagnoses could mimic asthma in this patient population, especially BO syndrome in those with GVHD.…”

Section: Discussionmentioning

confidence: 99%

Long-term acquisition of allergen-specific IgE and asthma following allogeneic bone marrow transplantation from allergic donors

Hallstrand

Sprenger

Agosti

et al. 2004

Blood

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Adoptive transfer of allergen-specific immunoglobulin E (IgE) from atopic donors to nonatopic recipients occurs during the first year following bone marrow transplantation (BMT). Mature B-and T-cell clones with allergen-specific memory and hematopoietic progenitor cells are transferred through BMT. The objective of this study was to characterize the long-term rate of allergic sensitization and development of clinical allergic diseases following BMT from atopic donors. A long-term follow-up study was conducted in a cohort of donor and recipient pairs with moderate-to-severe allergic disease in the donor prior to BMT. Assessments of allergen-specific IgE, clinical rhinitis, and asthma were made in the donors prior to BMT and in the recipients with a mean follow-up of 15.5 years after BMT. From an initial cohort of 12 bone marrow transplant recipients who received marrow from allergic donors, 5 long-term survivors were identified. Allergen-specific IgE transferred from donor to recipient following BMT frequently persisted, and a high rate of de novo allergic sensitization was observed between 1 and 14 years after BMT. These events were associated with elevation in total IgE, and development of allergic rhinitis and asthma at long-term follow-up. We conclude that marrowderived immune cells from allergic donors can transfer the predisposition to allergy and asthma. IntroductionAsthma and allergic diseases result from genetic and environmental influences. A unique opportunity to understand the development of asthma and allergy occurs during bone marrow transplantation (BMT) when recipients without allergic disease receive immune cells from allergic donors. We previously showed that recipients undergoing BMT from donors with moderate-to-severe allergic disease had a high rate of acquisition of donor allergen-specific immunoglobulin E (IgE) in the first year after transplantation consistent with adoptive transfer of B-and/or helper T-cell clones with allergen-specific memory. 1 Although our previous study and a number of case reports 2-6 have documented adoptive transfer of allergen-specific IgE in the first year following BMT from atopic donors, there are no long-term studies identifying the consequences of this initial adoptive transfer of allergen-specific IgE and immune cells during BMT from atopic donors. We conducted a long-term follow-up study more than 14 years after BMT in the same cohort of recipients that had received bone marrow transplants from donors with moderate-to-severe allergic disease and determined the long-term persistence of the IgE response and development of clinical allergic disease in recipients. We found that recipients had a high rate of persistence of transferred allergen-specific IgE, and acquisition of new allergen-specific IgE, elevated total IgE, allergic rhinitis, and asthma. This study suggests that marrow-derived immune cells transfer the predisposition to allergy and asthma and supports the primary role of immune cells in the development of the asthma phenotype. Patients, materials...

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Section: Discussionmentioning

confidence: 99%

Long-term acquisition of allergen-specific IgE and asthma following allogeneic bone marrow transplantation from allergic donors

Hallstrand

Sprenger

Agosti

et al. 2004

Blood

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“…3 Interestingly, there are also reports on the occurrence of immediate-type allergic reactions to common allergens after organ transplantation in patients with no known allergy before transplantation. [4][5][6][7][8][9][10][11][12][13] Hypotheses on the pathogenesis are diverse; for example, for liver transplantation, adoptive transfer of immunoglobulin E (IgE) antibody-loaded mast cells in the vascular pool of the allograft from allergic donors 9,11,13 and an allergy-promoting effect of distinct immunosuppressors (namely, the calcineurin inhibitor tacrolimus) have been discussed. 4,8,10,14,15 Because the immunosuppressive drugs used to prevent allograft rejection (steroids, calcineurin inhibitors, and proliferation inhibitors) strongly suppress the cellular immune system, in particular T and B lymphocytes, 16 which play a key role in IgE-mediated immediate-type allergic reactions as well, 17 it was expected that transplant recipients would not develop sensitizations or, at least, no clinical signs of allergy.…”

mentioning

confidence: 99%

Immunosuppressive Therapy Does Not Prevent the Occurrence of Immunoglobulin E–Mediated Allergies in Children and Adolescents With Organ Transplants

Dehlink¹,

Gruber²,

Eiwegger³

et al. 2006

Pediatrics

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“…33 Th2-biased immune reconstitution after HCT could be the mechanism for allergy "transfer." 42,43 Th2 cytokines like IL-4 and IL-10 may be up-regulated in allograft recipients 44 ; however, persistent Th2 bias as a routine consequence of HCT is unlikely because allergic disease is not commonly reported after HCT. We found only one case report that describes acquisition of allergy after allogeneic HCT from a nonallergic donor.…”

Section: Mechanism Of Transfer/cure Of Allergy With Allogeneic Hctmentioning

confidence: 99%

Is allergic disease curable or transferable with allogeneic hematopoietic cell transplantation?

Khan

Hallstrand

Geddes

et al. 2009

Blood

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Development of allergy post‐bone marrow transplantation

Cited by 7 publications

References 22 publications

Long-term acquisition of allergen-specific IgE and asthma following allogeneic bone marrow transplantation from allergic donors

Long-term acquisition of allergen-specific IgE and asthma following allogeneic bone marrow transplantation from allergic donors

Immunosuppressive Therapy Does Not Prevent the Occurrence of Immunoglobulin E–Mediated Allergies in Children and Adolescents With Organ Transplants

Is allergic disease curable or transferable with allogeneic hematopoietic cell transplantation?

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