Ljungman P, Lewensohn-Fuchs I, Hammarström V, Aschan J, Brandt L, Bolme P, Lönnqvist B, Johansson N, Ringdén O, Gahrton G
Department of Medicine, Huddinge University Hospital, Sweden.
Blood. 1994 Jul 15;84(2):657-63.
A total of 124 patients who had survived at least 2 years after allogeneic bone marrow transplantation (BMT) were studied. Serum was collected at least once yearly. IgG antibodies were determined by enzyme-linked immunosorbent assay for measles and mumps. Rubella antibodies were analyzed by radial hemolysis. Antibody levels were interpreted as representing immunity, seronegativity, or seropositivity, but with uncertain immunity. The median follow-up of the patients was 6.5 years (range, 2 to 13.5 years). The calculated probabilities of being immune to measles at 3, 5, and 7 years from BMT were 47%, 27%, and 20%, respectively. The corresponding probabilities for mumps were 37%, 12%, and 6%, respectively; and for rubella, 47%, 33%, and 28%, respectively. The probabilities for being seronegative for measles, mumps, and rubella at 5 years after BMT were 60%, 73%, and 52%, respectively. When compared with those patients who had experienced previous natural measles disease (P < .05), the only factor that was important for immunity to measles after BMT was whether the patient had been immunized before BMT. There was no influence of donor seropositivity on the probability of becoming seronegative to mumps during follow-up. We conclude that most allogeneic patients will become seronegative to measles, mumps, and rubella during follow-up. Therefore, long-term B-cell memory function is not maintained, regardless of the immune status of the donor.
对124例异基因骨髓移植(BMT)后存活至少2年的患者进行了研究。每年至少采集一次血清。采用酶联免疫吸附测定法测定麻疹和腮腺炎的IgG抗体。采用放射溶血法分析风疹抗体。抗体水平被解释为代表免疫、血清阴性或血清阳性,但免疫状态不确定。患者的中位随访时间为6.5年(范围为2至13.5年)。从BMT开始计算,3年、5年和7年时对麻疹免疫的概率分别为47%、27%和20%。腮腺炎的相应概率分别为37%、12%和6%;风疹的相应概率分别为47%、33%和28%。BMT后5年时,麻疹、腮腺炎和风疹血清阴性的概率分别为60%、73%和52%。与曾患过自然麻疹疾病的患者相比(P<0.05),BMT后对麻疹免疫的唯一重要因素是患者在BMT前是否接种过疫苗。供体血清阳性对随访期间腮腺炎血清阴性概率没有影响。我们得出结论,大多数异基因患者在随访期间麻疹、腮腺炎和风疹的血清学状态会转为阴性。因此,无论供体的免疫状态如何,长期的B细胞记忆功能都无法维持。