Premium
Prolonged neutropenia resulting from antibodies to neutrophil‐specific antigen NB1 following marrow transplantation
Author(s) -
Stroncek D. F.,
Shapiro R. S.,
Filipovich A. H.,
Plachta L. B.,
Clay M. E.
Publication year - 1993
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1993.33293158050.x
Subject(s) - medicine , neutropenia , bone marrow , immunology , granulocyte , absolute neutrophil count , antigen , antibody , transplantation , myeloid , chemotherapy
Marrow graft failure is a significant cause of morbidity following bone marrow transplantation. A case is reported of marrow graft failure due to neutrophil antibodies. A 13‐year‐old girl with a large granular lymphocytosis and chronic neutropenia was treated with granulocyte transfusions prior to undergoing a transplant with bone marrow from a partially matched, unrelated donor. Following the transplant, a bone marrow biopsy showed engraftment of donor myeloid cells, but the recipient remained neutropenic. Testing of the serum for neutrophil antibodies found that the recipient's serum had a high‐titer neutrophil antibody. Immunoprecipitation studies using the marrow recipient's serum and 125 I surface‐labeled neutrophils showed that the antibody reacted to the neutrophil‐specific antigen NB1. Phenotyping of neutrophils from the marrow donor found that they expressed NB1 antigen, and, in a crossmatch assay, the recipient's serum reacted with donor neutrophils. Despite treatment with granulocyte‐macrophage– colony‐stimulating factor, the marrow transplant recipient remained neutropenic and died of polymicrobial sepsis and aspergillosis 38 days after the transplant. The presence of high‐titer antibodies to neutrophil‐specific antigen NB1 in this patient following transplant likely prevented the recovery of her peripheral blood neutrophils and contributed to her death.