Graft-vs-host reaction following a single blood transfusion

Hathaway, William E.; Fulginiti, Vincent A.; Pierce, C W; Githens, John H.; Pearlman, David S.; F, Muschenheim; Kempe, Christopher

doi:10.1097/00007890-196805000-00043

Cited by 9 publications

(9 citation statements)

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“…Patients with immunologic deficiencies sometimes develop fatal graftversus-host disease (GVH) following the transfusion of whole blood or blood components [2,5,6]. It has been suggested that if blood is rendered free of immunocompetent leukocytes before transfusion, this syndrome can be prevented [4,7].…”

Section: Introductionmentioning

confidence: 99%

Immunocompetent Lymphocytes in Previously Frozen Washed Red Cells

Crowley¹,

Skrabut²,

Valeri³

1974

Vox Sanguinis

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Most of the leukocytes were removed from red cells during glycerolization, frozen storage at -80 °C, and washing. Residual lymphocytes that were isolated from the washed red cells were found to be responsive to phytohemagglutinin stimulation. Since phytohemagglutinin-responsive lymphocytes appear to mediate the graft-versus-host reaction, it is imperative that freeze-preserved red cells be handled with the same precautions as other blood products before transfusion to patients with immunologic deficiencies.

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Section: Introductionmentioning

confidence: 99%

Immunocompetent Lymphocytes in Previously Frozen Washed Red Cells

Crowley¹,

Skrabut²,

Valeri³

1974

Vox Sanguinis

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“…40,41 TA-GVHD is extremely rare and most commonly occurs in immunodeficient patients, although isolated reports of TA-GVHD in immunocompetent patients have been documented. [42][43][44] In summary, these preliminary data do not demonstrate a significantly increased rate of TA-MC in recipients of FrWB or plts compared with RBCs. Larger studies are needed to determine whether there is an increased rate of TA-MC in combat casualties transfused with FrWB.…”

Section: Discussionmentioning

confidence: 54%

Transfusion-Associated Microchimerism in Combat Casualties

Dunne

Lee

Burns

et al. 2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…21 In addition, transfusional GVHD in immunodeficient infants is characterized by the development of severe GVHD and aplastic anemia, as is transfusional GVHD in immunocompetent patients after open heart surgery. 22,23 In all the above examples, donor T-lymphocytes mediate host hematopoietic stem cell destruction and lead to the development of marrow aplasia and severe pancytopenia. However, unlike our experience, fatal GVHD developed in all the reported recipients.…”

Section: Resultsmentioning

confidence: 99%

Full hematopoietic engraftment after allogeneic bone marrow transplantation without cytoreduction in a child with severe combined immunodeficiency

Rubocki

Parsa

Hershfield

et al. 2001

Blood

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IntroductionSevere combined immunodeficiency (SCID) involves a failure of T cells to proliferate to various stimuli and a failure of B cells to produce specific antibodies. 1,2 Adenosine deaminase (ADA) deficiency, an autosomal recessive genetic defect, produces a SCID phenotype. 3,4 The enzyme defect leads to an abnormality in purine nucleoside metabolism that interferes with lymphocyte viability and function. ADA-deficient SCID is characterized by growth delay, candidiasis, respiratory infections, opportunistic infections, and, without specific therapy, early death. 5 Low or absent ADA activity in erythrocytes or other cells is diagnostic.Bone marrow transplantation (BMT) is effective therapy for SCID. The profound T-cell dysfunction associated with ADAdeficient SCID prevents graft rejection and permits BMT without conditioning with an HLA-matched sibling donor. 1,2,6 Success rates are greater than 90%, with full recovery of T-cell and B-cell functions. 6 Complete T-cell engraftment is routinely demonstrated, and approximately 50% of patients demonstrate engraftment of donor B cells. 7 Without conditioning, host hematopoiesis persists with no evidence of myeloid or erythroid engraftment. 5,[7][8][9] Study design J.L., a 17-month-old girl, presented with fever, vomiting, cough, skin ulcers, a history of failure to thrive, recalcitrant thrush, chronic respiratory infections, and recurrent otitis media. Immunizations were current. Family history was negative for immunodeficiency. Physical examination revealed an ill-appearing white female with weight and height below the fifth percentile, a paucity of lymph nodes, and no hepatosplenomegaly.Laboratory evaluation revealed normal hemoglobin and platelet counts. The white blood cell count was 1600/cmm (normal, 6000-17 000/cmm) and consisted of 10% neutrophils, 20% lymphocytes, 65% monocytes, and 4% eosinophils. Liver function test results were normal. Titers were negative for human immunodeficiency virus, cytomegalovirus, hepatitis B virus, herpes simplex virus, Epstein-Barr virus, adenovirus, poliovirus, Toxoplasma, and Chlamydia trachomatis.ADA activity was deficient in erythrocytes and in peripheral blood mononuclear cells; purine nucleoside phosphorylase (PNP) activity was normal in both cell types (Table 1). Metabolic findings in erythrocytes were consistent with ADA deficiency, including elevated deoxyadenosine nucleotide (dAXP) of 0.491 mol/mL packed cells (normal, less than 0.002 M/mL), and reduced S-adenosylhomocysteine hydrolase activity of 0.42 nmol/h/mg protein (normal, 4.2 Ϯ 1.9). 3 A 3-year-old sister was HLA-identical (A2, A3, B35, B27, Cw2, Cw4, DRB1*01, and DRB1*04). Without myeloablative or immunosuppressive therapy, the patient was infused with 7.6 ϫ 10 8 unfractionated nucleated marrow cells per kilogram from her sister. After BMT, the patient engrafted rapidly, remained well, and required no blood products (Figure 1). Biopsy-proven grade I skin graft-versus-host disease (GVHD) developed at day 39 after BMT and resolved with topical corticosteroid...

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Graft-vs-host reaction following a single blood transfusion

Cited by 9 publications

References 0 publications

Immunocompetent Lymphocytes in Previously Frozen Washed Red Cells

Immunocompetent Lymphocytes in Previously Frozen Washed Red Cells

Transfusion-Associated Microchimerism in Combat Casualties

Full hematopoietic engraftment after allogeneic bone marrow transplantation without cytoreduction in a child with severe combined immunodeficiency

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