OKT3 therapy for transfusion-associated graft-versus-host disease in a neonate.

Transfusion-associated graft-versus-host disease (TA-GVHD) is a fatal side effect of blood transfusion. The present study describes a case of TA-GVHD in a neonate treated with anti-CD3 monoclonal antibody (OKT3). The patient died of systemic bacterial infection. However, it is suggested that OKT3 suppressed the graft-versus-host reaction due to the improvement in the clinical signs and a change in the human leucocyte antigen (HLA) type on the surface of circulating lymphocytes. A relatively large dose of OKT3 together with steroid pulse therapy and cyclosporin A may be required for the control of TA-GVHD in neonates.