ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES (ANCA) IN CHRONIC GRAFT-VERSUS-HOST DISEASE AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION

We studied the usefulness of monitoring antineutrophil cytoplasmic ant ibodies (ANCA) in chronic graft-versus-host disease (cGVHD), a major c omplication of allogeneic bone marrow transplantation. Antigen-specifi c ELISA and indirect immunofluorescence (IIF) were used to search for ANCA in 47 allogeneic bone marrow graft recipients who developed cGVHD and in 43 who did not (controls), Eight patients exhibited ANCA IIF p ositivity in the cGVHD group, but none in the controls, Specificity wa s confirmed in antigen-specific assays in only two cGVHD patients, bot h showing antilactoferrin (anti-LF) activity, One of these patients wa s followed-up, and antilactoferrin antibodies were found only at the t ime of active but limited cGVHD, Among three ANCA IIF-positive patient s, two had antinuclear autoantibodies and three antineutrophil alloant ibodies secondary to blood transfusion, which may have been responsibl e for false ANCA IIF positivity, It is concluded that ANCA determinati on is not useful in patients with cGVHD, Polyclonal activation of B ly mphocytes could result in ANCA activity during cGVHD, False-positive A NCA could be due to allo-immunization following blood transfusion, Rar e patients may present antilactoferrin antibodies of unknown clinical significance.