Immunological recovery in 48 patients following syngeneic marrow transplantation or hematological malignancy.

Abstract

Immunological function of 48 syngeneic transplant patients prepared with 120 mg of cyclophosphamide per kg and 9.2 to 12.0 Gy (920 to 1000 rad) total body irradiation was compared with that of 153 allogeneic recipients. Lymphocyte counts and T cell numbers in syngeneic recipients were low during the first post-transplant month but higher than those of allogeneic recipients. Serum immunoglobulin levels in syngeneic recipients were normal by completion of the first post-transplantation month and were higher than allogeneic recipients at that time. Total hemolytic complement (CH/sub 50/) and third (C3) and fourth (C4) components were normal throughout the post-transplantation course in both groups of patients. Antibody production to primary injection of bacteriophage THETAX174 (Phage) was low in both syngeneic and allogeneic recipients during the first post-transplantation month and rose gradually thereafter. Some syngeneic recipients failed to produce normal amounts of IgG in their secondary response to phage. Antibody production after primary and secondary injection of keyhole limpet hemocyanin or pneumococcal polysaccharide was lower than normal early after grafting and rose later, comparable to that seen in allogeneic recipients. We conclude that immunological recovery in syngeneic recipients is very similar to recovery in allogeneic recipients except in the first month postgraftingmore » where twins are slightly better than allogeneic recipients for lymphocyte and immunoglobulin levels. Other mechanisms than those listed here must play an important role in protecting the syngeneic marrow graft recipient from opportunistic infection. (JMT)« less