A RAPID MOLECULAR DIAGNOSIS OF POSTTRANSFUSION GRAFT-VERSUS-HOST DISEASE BY POLYMERASE CHAIN-REACTION

A woman with recurrent Paget's disease of the vulva developed acute gr aft-versus-host disease (GVHD) 12 days after radical surgery and massi ve blood transfusion. Molecular diagnosis of lymphocyte chimerism in t he peripheral blood was made by polymerase chain reaction (PCR) direct ed against a Y chromosome-specific sex-determining region Y (SRY) gene . PCR with skin biopsy after onset of GVHD also revealed infiltration of SRY-positive donor lymphocytes. The diagnosis was confirmed by HLA- DNA typing with PCR-sequence-specific oligonucleotide that revealed th e presence of complex HLA-DR chimerism in the peripheral lymphocytes c ollected after onset of GVHD. The use of SRY-directed PCR is a rapid t echnique for the early diagnosis of acute posttransfusion GVHD in fema le patients.