Hammarström V, Pauksen K, Svensson H, Lönnqvist B, Simonsson B, Ringdén O, Ljungman P
Department of Hematology, Karolinska Institute, Huddinge University Hospital, Sweden.
Transplantation. 2000 Apr 27;69(8):1582-6. doi: 10.1097/00007890-200004270-00011.
The aim of this study was to investigate the correlation of total levels of immunoglobulins to levels of specific antibodies after allogeneic and autologous bone marrow transplantation. Autologous transplant patients had normal levels of IgA and IgG antibodies already at 6 months after transplantation. In allogeneic transplanted patients without chronic graft versus host disease the immunological recovery was slower. The IgA and IgG levels were at the limit for deficiency at 6 months after transplantation. In allogeneic transplant patients with chronic chronic graft versus host disease the immunological recovery was delayed further. The total IgG levels were low at 12 months after transplantation and the IgG subclass pattern did not normalize until 24 months after transplantation. IgA levels remained low at 24 months after transplantation in all allogeneic transplanted patients with chronic chronic graft versus host disease. Protective levels of specific antibodies against tetanus and pneumococci decreased during the first year after transplantation regardless of the total immunoglobulin levels, regardless of the donors immunity. Pneumococcal antibodies decreased only in allogeneic transplanted patients, although autologous transplant patients retained pretransplant immunity against pneumococci. There was no difference in levels of specific antibodies between patients with and without chronic chronic graft versus host disease at 12 months after transplantation. There was no correlation between total immunoglobulin levels to levels of specific antibodies against tetanus and pneumococci after transplantation in our study. Taken together, normalized immunoglobulin levels do not predict normalization of levels of specific antibodies against tetanus and pneumococci after transplantation.
本研究旨在调查异基因和自体骨髓移植后免疫球蛋白总水平与特异性抗体水平之间的相关性。自体移植患者在移植后6个月时IgA和IgG抗体水平已恢复正常。在没有慢性移植物抗宿主病的异基因移植患者中，免疫恢复较慢。移植后6个月时，IgA和IgG水平处于缺乏的临界值。在患有慢性移植物抗宿主病的异基因移植患者中，免疫恢复进一步延迟。移植后12个月时总IgG水平较低，IgG亚类模式直到移植后24个月才恢复正常。在所有患有慢性移植物抗宿主病的异基因移植患者中，移植后24个月时IgA水平仍较低。无论总免疫球蛋白水平如何，无论供体免疫状态如何，移植后第一年针对破伤风和肺炎球菌的特异性抗体保护水平均下降。肺炎球菌抗体仅在异基因移植患者中下降，尽管自体移植患者保留了移植前对肺炎球菌的免疫力。移植后12个月时，患有和未患有慢性移植物抗宿主病的患者之间特异性抗体水平没有差异。在我们的研究中，移植后总免疫球蛋白水平与针对破伤风和肺炎球菌的特异性抗体水平之间没有相关性。综上所述，免疫球蛋白水平正常并不能预测移植后针对破伤风和肺炎球菌的特异性抗体水平是否正常。
