Clinical immunobiology by Fritz H Bach; Robert A Good

By Fritz H Bach; Robert A Good

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Med. 257, 491-496. Thomas, E. , Herman, E. , Greenough, W. , I l l , Hager, E. , Cannon, J. , Sahler, O. , and Ferrebee, J. W. (1961). Irradiation and marrow infusion in leukemia. Arch. Intern. Med. 107, 829-849. Thomas, E. , Graham, T. C , and Storb, R. (1970). Marrow infusions in dogs given midlethal or lethal irradiation. Radiât. Res. 4 1 , 113-124. Thomas, E. , Rudolph, R. , and Buckner, C. D. (1971). Isogeneic marrow grafting in man. Exp. Hematol. 2 1 , 16-18. Thomas, E. , Buckner, C. , Neiman, P.

Only two of seven patients have had major episodes of infection. These observations have important implications with regard to the post-transplantation status of marrow graft recipients. Continued severe immunological deficiency in patients receiving allogeneic grafts points out the necessity for protection against infection and for vigilance in early detection and treatment of infection. Further observation and follow-up of these patients should determine whether or not they will show eventual complete recovery of immunological capability.

In recent marrow grafts carried out in Baltimore, Bethesda, and Seattle, almost all grafts were successful, as proved by cytogenetic analyses, when donor and recipient were of opposite sex. The few failures occurred in patients who had had multiple prior transfusions which may have sensitized them to minor transplantation antigens present by chance in the marrow donor. It appears that the secondary immune response of the host is not abrogated by massive immunosuppressive therapy. Support for this concept comes from dog studies and from one human patient in which, following graft rejection, host-type cells were demonstrated by cytogenetic analyses despite profound marrow hypoplasia.

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