ORIGINAL ARTICLES
Transfer of Atopy Following Bone Marrow Transplantation

https://doi.org/10.1016/S1081-1206(10)63240-1Get rights and content

Background

Bone marrow transplantation is an optimal treatment of acute leukemia and aplastic anemia. Allergic manifestations in recipients long after bone marrow transplantation have been reported. A case involving transfer of atopy manifested as food allergy-induced-atopic dermatitis in reported.

Methods

The donor and the patient were investigated by prick tests and RAST to the same food allergens. Single-blind, oral challenge to egg documented food allergy in the recipient.

Results

A 5-year-old boy without history of atopy developed severe atopic dermatitis after bone marrow transplantation from his HLA-identical sister for acute lymphoblastic leukemia. The patient's course had been marked previously by acute graft versus host disease and cytomegalovirus infection. Immunoallergic evaluation showed an exquisite sensitization to egg, peanut, and soybean. Total IgE was 6,400 KIU/L. Concomitantly, the donor showed the same sensitizations. Absolute avoidance resulted in the regression of atopic dermatitis. Subsequently, new sensitization to wheat flour, Dermatophagoides pteronyssinus, birch, and plantain pollens was detected. The donor developed asthma.

Conclusions

This case gives evidence of the transfer of sensitization from donor to recipient. The passive transfer of memory cells within the bone marrow inoculum is a possible mechanism. The current concept of allergy supports down regulation of Th1 cells to the benefit of Th2 cells. Additional deregulation induced by acute graft versus host disease, cytomegalovirus infection, and immunosuppression is possible.

References (25)

  • TR Mosmann et al.

    Th1 and Th2 celles: different patterns of lymphockine secretion lead to different functional properties

    Ann Rev Immunol

    (1989)
  • S Romagnani

    Lymphokine production by human T cells in disease states

    Ann Rev Immunol

    (1994)
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