The Mixed Epidermal Cell Lymphocyte Reaction Allows the Detection of Alloreactivities Before Graft in HLA Identical Siblings

Abstract

Graft-Versus-Host-Disease (GVHD) remains a major clinical problem, sometimes leading to life threatening complications in patients treated by marrow transplantation from HLA identical siblings. Cutaneous signs are both the earliest and the most constant manifestations in acute GVHD, suggesting that epidermal cells (EC) could be a preferential target of this reaction. It has been shown that human EC induce greater proliferations of allogeneic lymphocytes in the mixed-epidermal-cell-lymphocyte-reaction (MECLR) than the same number of peripheral blood lymphocytes (PBL) in the mixed-lymphocyte-reaction (MLR) (Sontheimer et al., 1983). Moreover, EC could allow the detection of weak proliferative responses not found in MLR, especially in primary reactions (Begot et al., 1985). In this study, we tested the ability of MECLR to detect alloreactivities before graft in HLA identical MLR negative siblings and to predict the patients’ evolution after grafting.