PATERNAL LEUKOCYTE IMMUNIZATION IN PRIMARY RECURRENT SPONTANEOUS ABORTERS

This was a pilot study to investigate the possible roles of human lymp hocyte antigen (HLA), antipaternal lymphocytotoxic antibodies. and mat ernal antipaternal mixed lymphocyte reaction (MLR) blocking antibodies in the maintenance of pregnancy following paternal leukocyte immuniza tion for patients with recurrent abortions. A total of 36 patients wit h unexplained, first trimester, primary recurrent spontaneous abortion s were investigated for the detection of these two antibodies. There w as a 43.3% rate of discordance in the presence of the two antibodies ( P<0.05). A total of 26 of these women who lacked either antibody were immunized with paternal leukocytes on two occasions and the assays wer e repeated post-immunization. The seroconversion rate was 50% for lymp hocytotoxic antibodies and 61.5% for maternal serum (MLR) blocking ant ibodies. Twenty patients achieved pregnancies post-immunization, 11 co mpleted their pregnancies successfully, and 9 re-aborted. A total of 8 3.3% of patients who developed MLR blocking antibodies post-immunizati on had successful pregnancies while those who failed to seroconvert ab orted again. This difference is statistically significant (P<.05). A t otal of 50% of patients who developed lymphocytotoxic antibodies post- immunization had successful pregnancies while only 40% who failed to s eroconvert re-aborted. This difference, we felt, was not statistically significant. The development of MLR blocking antibodies post-immuniza tion is a better indicator of subsequent successful pregnancies than l ymphocytotoxic antibodies.