Ap. Schwarer et al., COMPARISON OF HELPER AND CYTOTOXIC ANTIRECIPIENT T-CELL FREQUENCIES IN UNRELATED BONE-MARROW TRANSPLANTATION, Transplantation, 58(11), 1994, pp. 1198-1203
Donor/recipient histocompatibility antigen differences initiate acute
graft versus-host disease (GVHD) after bone marrow transplantation. Fr
equency analysis, using limiting dilution techniques, of functionally
defined (helper or cytotoxic) antirecipient T lymphocyte precursors in
the peripheral blood of the donor has been shown to be an accurate pr
edictor for the development of moderate-to-severe acute GVHD. Here, we
describe a sensitive assay for measuring alloreactive helper (IL-2-pr
oducing) T lymphocyte precursor (HTLp) frequencies, and compare the ab
ility of this assay and the cytotoxic T lymphocyte precursor (CTLp) as
say to detect HLA- class II and class I differences and to predict cli
nical outcome in a cohort of unrelated donor/recipient BMT pairs. Twen
ty-two pairs underwent unrelated donor BMT. Patients with high (>1:100
x10(3)) HTLp or CTLp frequencies had a higher incidence of moderate-to
-severe (grades II-IV) acute GVHD (80% and 100%, respectively) than pa
irs with low (<1:100x10(3)) frequencies (40% and 57%, respectively). T
en (45%) patients have died, but all patients with both a low HTLp and
low CTLp frequency remain alive. The HTLp and CTLp assays provided si
milar predictive information for outcome. Given that the HTLp assay is
more rapid and less labor intensive, it offers an additional or alter
native functional method for donor selection in unrelated donor BMT.