UNEXPLAINED HABITUAL ABORTIONS - EXPERIEN CE WITH THE ACTIVE IMMUNOTHERAPIE

The effect of lymphocyte transfusions on the stabilisation and success ful outcome of pregnancy was investigated in 30 women with recurrent a bortions presumably caused by immunologic factors. Lymphocyte concentr ates were obtained from stored whole blood of the husbands and transfe rred by intravenous injection. Exclusion criteria for this study were the presence of antipaternal lymphocytotoxic antibodies in the patient 's serum (cross match) or an advanced pregnancy (>12 weeks). After tra nsfusion of paternal lymphocytes 19 (63%) women had uncomplicated and successful pregnancies whereas 11 (37%) suffered again from early preg nancy loss. Two out of these 11 patients aborted twice. The probabilit y of a successful treatment decreased as soon as lymphocytotoxic antib odies appeared in the patient's serum (p less than or equal to 0.021). Women with a lower number of abortions before treatment carried their pregnancies to full term more frequently (p less than or equal to 0.0 3). The number of transfusions, the period between start of treatment and conception as well as the distribution of age within the two group s had no significant effect on the outcome of therapy. A lack of lymph ocytotoxic antibodies or their late appearance during treatment give a positive prognosis for the progress of pregnancy. Compared with a fer tile control group, couples with habitual abortions showed no signific antly increased HLA sharing. Immunisation with paternal lymphocytes in cases of presumably habitual abortions due to immunologic factors app ears as an effective therapy with only few side effects. Large, random ised, double-blind, and placebo-controlled trials are needed before dr awing conclusions.