ANAPHYLAXIS DURING AUTOLOGOUS PERIPHERAL-BLOOD PROGENITOR-CELL INFUSION

Anaphylaxis has been reported in subjects receiving peripheral blood p recursor cell (PBPC) infusions; however the etiologic agent is unclear , Basophils from a PBPC-allergic subject were challenged with each ind ividual component of the stem cell infusion and with recombinant human (rh)DNAse. Histamine release data were compared with those using baso phils from control subjects, Histamine release assays were repeated us ing basophils from a control subject passively sensitized with serum I gE from the patient, Skin testing with bovine DNAse was performed usin g standard techniques, Basophil histamine release occurred in the pati ent, but not in controls, with bovine DNAse, No release could be provo ked by any of the other components of the infusate; no release could b e detected with rhDNAse. Sensitivity to bovine DNAse could be transfer red to basophils from a control subject with the serum IgE from the pa tient, Marked epicutaneous skin test reactivity to bovine DNAse was ev ident in the patient, but not in control subjects, We conclude that sy stemic reactions during peripheral blood precursor cell infusions mag represent true IgE-mediated anaphylaxis to bovine DNAse in the infusat e, Skin testing can detect such sensitivity, and the use of rhDNAse ma y obviate such reactions.