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Pretransfused patients with severe aplastic anaemia exhibit high numbers of cytotoxic T lymphocyte precursors probably directed at non‐HLA antigens
Author(s) -
Kaminski E. R.,
Hows J. M.,
Goldman J. M.,
Batchelor J. R.
Publication year - 1990
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1990.tb06375.x
Subject(s) - ctl* , immunology , cytotoxic t cell , human leukocyte antigen , antigen , medicine , peripheral blood mononuclear cell , bone marrow , immune system , biology , cd8 , biochemistry , in vitro
Summary Patients with severe aplastic anaemia (SAA) have a relatively high risk of graft rejection after transplantation of bone marrow from HLA‐identical siblings compared with patients transplanted for leukaemia. This is presumed to be due to pretransplant blood transfusions which sensitize the recipient's immune system to non‐HLA antigens expressed on donor marrow cells. To test this hypothesis, we estimated in the peripheral blood of 18 SAA patients, the frequencies of alloreactive cytotoxic T lymphocyte precursors (CTL‐p) directed against mononuclear cells from syngeneic twins, HLA‐identical siblings or HLA‐matched unrelated individuals. The results were compared with the frequencies of CTL‐p in 13 healthy subjects or leukaemia patients who had not been transfused. Pretransfused patients with SAA had significantly higher frequencies of CTL‐p directed against HLA‐identical siblings ( P = 0·002), and against HLA‐matched unrelated individuals ( P = 0·004), than did untransfused individuals. In contrast, the frequency of CTL‐p in two pretransfused patients against syngeneic mononuclear cells was very low. We propose that the increased numbers of CTL‐p in the blood of pretransfused SAA patients are directed against non‐HLA antigens on target cells and may be the result of prior blood transfusion.