Induction of graft-versus-host disease after autologous bone marrow transplantation

To induce graft-versus-host disease (GvHD) in patients undergoing autologous bone marrow transplantation (BMT), five consecutive patients with non-Hodgkin lymphoma or Hodgkin's disease in resistant relapse were treated with cyclophosphamide and total body irradiation or busulphan and cyclophosp...

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Bibliographic Details
Published inThe Lancet (British edition) Vol. 1; no. 8641; p. 754
Main Authors Jones, R J, Vogelsang, G B, Hess, A D, Farmer, E R, Mann, R B, Geller, R B, Piantadosi, S, Santos, G W
Format Journal Article
LanguageEnglish
Published England 08.04.1989
Subjects
Acute Disease
Adult
Autoimmune Diseases - chemically induced
Bone Marrow Transplantation
Chronic Disease
Cyclosporins - adverse effects
Female
Graft vs Host Disease - chemically induced
Graft vs Host Disease - immunology
Histocompatibility Antigens Class II - immunology
Hodgkin Disease - immunology
Hodgkin Disease - therapy
Humans
Lymphoma, Non-Hodgkin - immunology
Lymphoma, Non-Hodgkin - therapy
Male
Middle Aged
Skin Diseases - chemically induced
Skin Diseases - immunology
T-Lymphocytes, Cytotoxic - immunology
Transplantation, Autologous
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Summary:To induce graft-versus-host disease (GvHD) in patients undergoing autologous bone marrow transplantation (BMT), five consecutive patients with non-Hodgkin lymphoma or Hodgkin's disease in resistant relapse were treated with cyclophosphamide and total body irradiation or busulphan and cyclophosphamide, followed by autologous BMT. The patients received cyclosporin 1 mg/kg per day intravenously for 28 days after BMT. Histologically proven grade II acute GvHD of the skin developed in all the patients at a median of 11 days (range 9-13) after BMT. One patient died and the GvHD resolved in 1-3 weeks in the four remaining patients--spontaneously in two and with corticosteroid treatment in two. Lymphocytes from one patient obtained at the time of GvHD were cytotoxic for the patient's own pretransplant lymphocytes. Cytotoxicity was blocked by antibodies directed against class II histocompatibility (HLA-DR or Ia) antigens. Cyclosporin-induced GvHD after autologous BMT resembles mild GvHD after allogeneic grafting. This syndrome appears to be mediated by autoreactive Ia-specific lymphocytes.
ISSN:0140-6736
1474-547X