Platelet- and Granulocyte-Specific Antibodies after Allogeneic and Autologous Bone Marrow Grafts

Abstract

After bone marrow grafting, severe unexplained thrombocytopenia and granulocytopenia may complicate the post-graft recovery of the patient. The present study has shown the presence of antibodies to platelets and granulocytes of donor origin in recipients of both allogeneic and autologous bone marrow grafts. In the case of autografts, such antibodies are by definition autoantibodies, and similar antibodies after allografting may also have an autoimmune origin. It is likely that this is the result of transient immune system imbalance, common to both alio- and autografts, in the early post-graft period. The extent to which these antibodies affect the peripheral counts probably depends on the ability of the engrafted marrow to compensate for the rate of antibody-mediated cell destruction.

Factors influencing haematological recovery in 53 patients with acute myeloid leukaemia in first remission after autologous bone marrow transplantation

“…The frequency of 50-60% found in our study is similar to that in other reports (Bierling et al 1983;Minchinton et al, 1984). The majority of platelet antibodies are assumed to be autoantibodies, even in the allograft setting, and their development may be due to the abnormal immune environment following BMT (Minchinton et al 1984). In common with Minchinton et al (1984) we have shown that there is no correlation between platelet count and elevated PAIgG.…”

“…Elevated PAIg occurs commonly in patients following chemotherapy, or undergoing either autologous or allogeneic BMT for haematological malignancy. The frequency of 50-60% found in our study is similar to that in other reports (Bierling et al 1983;Minchinton et al, 1984). The majority of platelet antibodies are assumed to be autoantibodies, even in the allograft setting, and their development may be due to the abnormal immune environment following BMT (Minchinton et al 1984).…”

Serological Screening, Using Three Different Test Systems of Platelet-Transfused Patients with Hematologic-Oncologic Disorders

“…The increasing use of such antibodies should be kept in mind. The LCT will also be positive with lymphocyte-specific non-HLA antibodies, such as autoantibodies; these are most often observed in BMT patients, a well-known phenomenon described by others, too [14].…”

Prospective Evaluation of the Chemiluminescence Test for the Detection of Granulocyte Antibodies: Comparison with the Granulocyte Immunofluorescence Test

“…However, in sera from patients with Felty's syndrome, the incidence of positive reactions (89.5%) and the proportion of anti-granulocyte IgM antibodies was considerably greater than in other patient groups. The finding of serum-reactive factors in patients with Felty's syndrome contrasts with other studies which have reported elevated levels of membrane-bound immunoglobulins on the surface of granulocytes from these patients but an absence of granulocyte-reactive serum factors [21, 221. Granulocyte-specific antibodies have also been documented in bone marrow transplant recipients who may develop granulocyte autoantibodies either during the reestablishment of normal immune and haemopoietic systems [23,24] or, more unusually, at a later stage [13] and in patients with a history of febrile or pulmonary transfusion reactions [25, 261. This study confirmed the presence of granulocyte-specific antibodies as detected by both the GCLT and/or the GIFT in a proportion of both of these two groups of patients (table 1).…”