Transfusion‐Related Risks of Intradermal Allogeneic Lymphocyte Immunotherapy: Single Cases in a Large Cohort and Review of the Literature

Kling, Christiane; Steinmann, Jörg; Flesch, Brigitte K.; Westphal, E.; Kabelitz, Dieter

doi:10.1111/j.1600-0897.2006.00413.x

Cited by 17 publications

(16 citation statements)

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“…The study cohort comprised women who had been referred to the Institute of Immunology, University Schleswig-Holstein, Campus Kiel, Germany for lymphocyte immunotherapy (LIT) as treatment for infertility in patients with recurrent first trimester miscarriage and/or patients with recurrent embryo implantation failure after in vitro fertilisation. LIT was introduced at the Institute of Immunology, University Schleswig-Holstein, Campus Kiel, Germany in the 1980s, is approved by the local health authority and is covered by the national health insurance providers (70,71). LIT comprised a single intradermal injection of lymphocytes isolated from 50mls of peripheral venous blood obtained from their male partner.…”

Section: Lymphocyte Immunotherapy Patient Cohortmentioning

confidence: 99%

Predicting humoral alloimmunity from differences in donor-recipient HLA surface electrostatic potential

Mallon

Kling

Robb

et al. 2018

Preprint

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In transplantation, development of humoral alloimmunity against donor HLA is a major cause of organ transplant failure but our ability to assess the immunological risk associated with a potential donor-recipient HLA combination is limited. We hypothesised that the capacity of donor HLA to induce a specific alloantibody response depends on their structural and physicochemical dissimilarity compared to recipient HLA. To test this hypothesis, we first developed a novel computational scoring system that enables quantitative assessment of surface electrostatic potential differences between donor and recipient HLA molecules at the tertiary structure level (electrostatic mismatch score-three dimensional; EMS-3D). We then examined humoral alloimmune responses in healthy females subjected to a standardised injection of donor lymphocytes from their male partner. This analysis showed a strong association between the EMS-3D of donor HLA and donor-specific alloantibody development; this relationship was strongest for HLA-DQ alloantigens. In the clinical transplantation setting, the immunogenic potential of HLA-DRB1 and -DQ mismatches expressed on donor kidneys, as assessed by their EMS-3D, was an independent predictor of development of donor-specific alloantibody after graft failure. Collectively, these findings demonstrate the translational potential of our approach to improve immunological risk assessment and to decrease the burden of humoral alloimmunity in organ transplantation.All rights reserved. No reuse allowed without permission.(which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.

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Section: Lymphocyte Immunotherapy Patient Cohortmentioning

confidence: 99%

Predicting humoral alloimmunity from differences in donor-recipient HLA surface electrostatic potential

Mallon

Kling

Robb

et al. 2018

Preprint

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“…The efficacy of the immunotherapy has been controversial [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23], but a meta-analysis concerning the immunotherapy for patients with URA reported by the Recurrent Miscarriage Immunotherapy Trialists Group in 1994 [13], Clark in 2008 [7] and 2012 [14] concluded and Liu et al in 2016 [25] concluded that the immunotherapy may be highly effective. In addition, Pandey et al reported a significant improvement in pregnancy outcome in the patient group in their double-blind randomized trial of husband's lymphocyte immunization for women with recurrent spontaneous abortion [19].…”

Section: Discussionmentioning

confidence: 99%

“…Immunotherapy for these patients using their husbands' or a third party's leukocytes has been reported [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Although the efficacy of this modality has been controversial, an analysis of controlled clinical trials revealed the efficacy for patients with Unexplained Recurrent Abortion (URA) [7,14,19,26,27], especially for those who were negative for blocking antibodies evaluated by a mixed lymphocyte culture reaction between spouses (MLR-BAbs) [19,22,[28][29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

Studies on the Infants Born to the Patients with Unexplained Recurrent Abortion Who Underwent Immunotherapy using their Husband’s Lymphocytes

Takakuwa¹

2017

Austin J Obstet Gynecol

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Purpose: To investigate the condition of infants born to the patients who underwent Immunotherapy with the Husband's Lymphocytes (LIT) for unexplained recurrent abortion.Method: LIT was performed for the patients with unexplained recurrent abortion, and the pregnancy continued in 129 cases after LIT. The Gestational Weeks at Delivery (GW), the Body Weights (BW) of the infants, as well as major complications, were analyzed in these patients. As a control, the pregnancy outcome was analyzed in 243 cases with no complications and who did not receive LIT.Results: Of 125 cases with singleton pregnancy (4 cases were excluded because of twins), the pregnancy terminated at term in 113 (90.4%), which was not significantly different from that in the control group (209/243, 86.0%, by the Chi-square test). The average GW and BW of infants in the study population and control group were 38W4D ± 2W0D and 38W4D ± 2W3D, 2968 ± 529g and 2904 ± 583g, respectively (not significant by non-paired t-test). There were also no significant differences in the rates of low birth weight and major complications between the two groups. Conclusion:The outcome of pregnancies, especially the condition of infants, of patients after LIT was not significantly different from that of a control population.

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“…Zwischen 1999 und 2002 wurden 1700 Paare nach mindestens drei erfolglosen Eizellpunktionen und Embryotransfers mittels Lymphozyten-Immuntherapie (LIT) nach beschriebener Methodik [9,10] Allgemeiner Ausgang nach wiederholtem Implantationsversagen Nach Ablauf von zwei Jahren wurden insgesamt 363 von 1435 Paaren (25 %) Eltern nach Embryotransfer in Deutschland und 88 Paare (6 %) nach spontaner Schwangerschaft. Neben IVF wurden noch andere Wege beschritten, sodass sich schließlich bei 541 Paaren (38 %) der Kinderwunsch erfüllte.…”

Section: Befragungunclassified

Verlauf 2 Jahre nach wiederholtem Implantationsversagen im IVF-Programm

Kling¹,

Wilke²,

Schmutzler³

et al. 2007

Geburtshilfe Frauenheilkd

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Fragestellung: Bei Implantationsversagen im IVF-bzw. ICSI-Programm brauchen die Paare Informationen zur Prognose bei weiterer Kinderwunschbehandlung. Die kumulative Geburtenrate als notwendige Beratungsgrundlage ist jedoch wegen Praxiswechsels schwer festzustellen. Alternativ wurden Paare nachverfolgt, die bundesweit an das Institut für Immunologie in Kiel überwiesen wurden. Material und Methodik: Zwischen 1999 und 2002 wurden 1700 Paare nach mindestens drei erfolglosen Punktionszyklen adjuvant mittels Lymphozyten-Immuntherapie (LIT) behandelt. Diese sowie die 47 einsendenden Fachpraxen wurden zwei Jahre später zum weiteren Verlauf befragt. Die Rückmelderate betrug 84,4 % (1435 Paare). Ergebnisse: Der LIT waren 3,7 ± 0,8 Punktionszyklen bzw. 4,3 ± 1,2 Embryotransfers vorangegangen. Mit knapp 2 Embryotransfers setzten 1252 Paare (87,2%) die IVF-Behandlung in Deutschland fort, und 183 Paare (12,8 %) brachen ab. Der Kinderwunsch erfüllte sich für 541 von 1435 Paaren (38 %): bei 363 (25 %) nach Embryotransfer, 88 (6 %) nach spontaner Konzeption, 23 (2%) nach anderen ART und bei 67 (5%) durch Adoption oder Pflegschaft. 256 Paare (18%) entschieden sich für ein Leben ohne Kinder, wäh-rend 275 Paare (19%) die Behandlung fortsetzen wollten und 288 Paare (20 %) sich nicht zu weiteren Plänen äußerten. Bei Frauen unter 30 Jahren lag die IVF-Geburtenrate pro Paar doppelt so hoch wie bei Frauen über 39 Jahren (39,5 vs. 18,1%, p < 0,005). Bereitschaft zum Praxiswechsel beeinflusste die IVF-Chancen nicht signifikant. Schlussfolgerung: Eine Fortsetzung der IVF-Behandlung verbessert altersabhängig die Prognose, jedoch ist die Behandlung oft nach acht Jahren Kinderwunsch noch nicht abgeschlossen. Daher sollte die Beratung auch mögliche AlternatiAbstract !Purpose: After recurrent IVF or ICSI implantation failure couples need information on their further prognosis. Dropping-out is frequent in this group, and IVF centres therefore have difficulty in establishing the basis for counselling. As an alternative, patients treated adjuvantly by lymphocyte immunotherapy (LIT) at the Kiel Institute of Immunology were evaluated. Materials and Methods: From 1999 to 2002, 1700 consecutive couples received LIT after at least three unsuccessful oocyte retrievals and embryo transfers. They were contacted two years later together with the 47 referring IVF centres. The response rate was 84.4 % (1435 cases). Results: Previous to undergoing LIT, the couples had 3.7 ± 0.8 oocyte retrievals and 4.3 ± 1.2 transfers. 1252 couples (87.2%) had another 2 transfers on average, while 183 couples (12.8 %) refrained from IVF therapy. 541 couples (38 %) became parents: 363 couples (25 %) after embryo transfer, 88 (6 %) after spontaneous conception, 23 (2 %) after alternative ART and 67 (5%) through adoption. Another 256 couples (18%) decided to remain childless, while 275 couples (19%) wanted to continue in the IVF programme. The issue was uncertain in 288 couples (20 %). For women below the age of 30, the IVF birth rate per couple was twice that of women over the ...

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Transfusion‐Related Risks of Intradermal Allogeneic Lymphocyte Immunotherapy: Single Cases in a Large Cohort and Review of the Literature

Abstract: Based on microbiological, immunological, and hematological testing the risks of intradermal LIT are low.

Cited by 17 publications

References 61 publications

Predicting humoral alloimmunity from differences in donor-recipient HLA surface electrostatic potential

Predicting humoral alloimmunity from differences in donor-recipient HLA surface electrostatic potential

Studies on the Infants Born to the Patients with Unexplained Recurrent Abortion Who Underwent Immunotherapy using their Husband’s Lymphocytes

Verlauf 2 Jahre nach wiederholtem Implantationsversagen im IVF-Programm

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