Serum immunoglobulin levels following allogeneic bone marrow transplantation

Abstract

In order to study the posttransplant evolution of serum immunoglobulin levels, we measured serum IgG, IgA and IgM levels in 50 recipients of allogeneic bone marrow before transplantation and at different intervals thereafter (days 39, 120, 365 and 730). IgG and IgM levels were depressed for 1 year and IgA levels for 2 years posttransplant. Immunoglobulin deficiency was more severe and prolonged in patients with graft versus-host-disease. Hypogammaglobulinemia may contribute to the frequent infections observed in these patients, especially those with chronic graft-versus-host disease.

No alloantibodies against mesenchymal stromal cells, but presence of anti-fetal calf serum antibodies, after transplantation in allogeneic hematopoietic stem cell recipients

“…44 Still, substantial levels of immunoglobulins and plasma cells of recipient origin are present for up to 1 year post-HSCT. 45,46 Furthermore, peripheral blood HSCT is associated with increased levels of alloantibodies.…”

The lack of memory B cells including T cell independent IgM+ IgD+ memory B cells in chronic graft-versus host disease is associated with susceptibility to infection

“…Defects of humoral immunity together with hypogammaglobulinaemia are well documented [13,[40][41][42]. IgG serum levels can be taken as surrogate markers for B cell function.…”

Immune reconstitution post allogeneic transplant and the impact of immune recovery on the risk of infection

“…107 However, although the levels of IgG1 and IgG3 normalize during the first year after HCT, the deficiencies of IgG2 and IgG4 persist for more than 18 months. 19,20,106,107,114,[121][122][123] As lgG2 responses are protective against capsular carbohydrate antigens from gram-positive bacteria, 124 prolonged deficiency of IgG2 can explain the undue susceptibility of HCT recipients to late bacterial infections. The last immunoglobulin to recover is IgA, which may be undetectable for several years.…”

“…The deficiencies of immunoglobulins is much more pronounced and prolonged in those who develop GVHD or those who receive antithymocyte globulin (ATG). 19,107,121,125 However, interestingly, the functional recovery of B cells is similar after T-replete or T-deplete HCT, 107 and after B-and T-deplete PB graft (CD34C selected) vs. unmanipulated grafts. 126 The functional immaturity of donor-derived lymphocytes, combined with a decrease in the recipient plasma cells and Ig levels over time, result in the loss of immunity against viral and bacterial pathogens attained through childhood vaccination or infection.…”