THE PRODUCTION OF MLR-BLOCKING FACTORS AFTER LYMPHOCYTE IMMUNOTHERAPYFOR RSA DOES NOT PREDICT THE OUTCOME OF PREGNANCY

PROBLEM: The questions of whether production of mixed lymphocyte react ion-blocking factors (MLR-BFs) after immunotherapy with lymphocytes fo r recurrent spontaneous abortion (RSA) has prognostic value and whethe r cytotoxic antibodies are also involved were tested. METHOD OF STUDY: A prospective study with 33 patients who had a history of two or more abortions, lacking MLR-BFs, was carded out. The patients received imm unizations with lymphocytes and 6 weeks or later were tested for seroc onversion of MLR-BFs. Seventeen of these thirty-three patients were ev aluated for antipaternal cytotoxic antibodies. The results were correl ated with the outcome of the next pregnancy after treatment. RESULTS: Eighty percent of the 33 patients had a live child. Of those patients having success, only 50% produced MLR-BFs. Of those patients having a new loss, five did and two did not produce MLR-BF (P > 0.05). Regardin g the 17 patients tested for cytotoxic antibodies, 4 of the 5 patients who tested positive had a new abortion, whereas only 1 of 12 whose te sts remained negative did not have gestational success (P < 0.01). CON CLUSION: The presence of MLR-BFs is not a prognostic criterium for the outcome of pregnancy after alloimmunotherapy, and, consequently, it i s not a good diagnostic tool for RSA of alloimmune cause.