Tp. Loughran et Mk. Shriver, SEROPREVALENCE OF HTLV-I AND HTLV-II IN MARROW TRANSPLANT RECIPIENTS, Bone marrow transplantation, 14(3), 1994, pp. 433-436
HTLV-I and HTLV-II can both be transmitted through blood transfusions.
Although the seroprevalence of HTLV-I/II in volunteer blood donors in
low, patients with leukemia who received multiple blood transfusions
are at increased risk for HTLV-I/II infection. Patients undergoing mar
row transplantation for malignant and non-malignant diseases have ofte
n received multiple transfusions prior to transplantation. The seropre
valence of HTLV-I/II in marrow transplant recipients is not known, how
ever. We studied pre-transplant sera from 317 patients receiving allog
eneic or syngeneic marrow transplant in 1988 for antibodies to HTLV-I/
II using an ELISA. Six sera were positive in this assay and nine other
sera had absorbance values elevated above background. One of these 15
sera was confirmed positive in a Western blot assay; six others had a
n indeterminate reactivity. The seropositive patient was infected with
HTLV-I and not HTLV-II as determined using a synthetic peptide-based
ELISA; the indeterminate sera did not show reactivity to either HTLV-I
or HTLV-II in this assay. Differentiation of HTLV-I from HTLV-II infe
ction was also shown using a modified recombinant Western blot assay i
n which the seropositive patient showed reactivity to recombinant HTLV
-I env gp46 and not recombinant HTLV-II env gp46. These results show i
nfection with HTLV in one of 317 patients (0.3%) prior to marrow trans
plantation. The clinical consequences resulting from HTLV-I/II seropos
itivity during the severe immunosuppression accompanying marrow transp
lantation are not known. Testing blood donors for HTLV-I/II as is curr
ently practised should reduce seroprevalence of HTLV-I/II in previousl
y transfused marrow transplant recipients.