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. 1996 Sep;55(9):638–641. doi: 10.1136/ard.55.9.638

Transplantation with allogenic bone marrow from a donor with systemic lupus erythematosus (SLE): successful outcome in the recipient and induction of an SLE flare in the donor.

G Sturfelt 1, S Lenhoff 1, B Sallerfors 1, O Nived 1, L Truedsson 1, A G Sjöholm 1
PMCID: PMC1010261  PMID: 8882135

Abstract

OBJECTIVE: To investigate the transfer of autoimmunity by allogenic bone marrow transplantation. METHODS: Bone marrow transplantation was performed in a 43 years old man with acute myeloid leukaemia (AML) in remission. The donor was his HLA identical brother who had a mild systemic lupus erythematosus (SLE). Autoantibodies, including antinuclear, anti-C1q, and anticardiolipin antibodies, were measured before and after transplantation. RESULTS: Transient mild graft versus host disease (GvHD) developed in the recipient in the weeks following transplantation. The donor had persistently high concentrations of anti-C1q antibodies to the collagenous region of the complement component C1q. Three months after transplantation the recipient developed antiC1q antibodies that persisted for two months. No other autoantibodies and no SLE-like manifestations appeared. Chronic GVHD started five months posttransplant and responded to intensified immunosuppressive treatment. Three years post-transplant the patient was in unmaintained remission. Within a few weeks after bone marrow donation the donor's disease was exacerbated with development of severe pulmonary alveolitis which required treatment with cyclophosphamide. CONCLUSIONS: When bone marrow transplantation was performed in a patient with AML with bone marrow from an HLA identical brother who had SLE, no evidence of transfer of disease was obtained. However, the recipient temporarily produced anti-C1q antibodies which was a characteristic feature of the donor's SLE and was probably produced by the transplant. The flare of the donor's SLE might be related to the bone marrow tap.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Frémeaux-Bacchi V., Weiss L., Brun P., Kazatchkine M. D. Selective disappearance of C3NeF IgG autoantibody in the plasma of a patient with membranoproliferative glomerulonephritis following renal transplantation. Nephrol Dial Transplant. 1994;9(7):811–814. [PubMed] [Google Scholar]
  2. Holmskov U., Malhotra R., Sim R. B., Jensenius J. C. Collectins: collagenous C-type lectins of the innate immune defense system. Immunol Today. 1994 Feb;15(2):67–74. doi: 10.1016/0167-5699(94)90136-8. [DOI] [PubMed] [Google Scholar]
  3. Levite M., Zinger H., Mozes E., Reisner Y. Systemic lupus erythematosus-related autoantibody production in mice is determined by bone marrow-derived cells. Bone Marrow Transplant. 1993 Sep;12(3):179–183. [PubMed] [Google Scholar]
  4. Minchinton R. M., Waters A. H., Kendra J., Barrett A. J. Autoimmune thrombocytopenia acquired from an allogeneic bone-marrow graft. Lancet. 1982 Sep 18;2(8299):627–629. doi: 10.1016/s0140-6736(82)92738-6. [DOI] [PubMed] [Google Scholar]
  5. Schlansky R., DeHoratius R. J., Pincus T., Tung K. S. Plasmapheresis in systemic lupus erythematosus: a cautionary note. Arthritis Rheum. 1981 Jan;24(1):49–53. doi: 10.1002/art.1780240108. [DOI] [PubMed] [Google Scholar]
  6. Smith C. I., Aarli J. A., Biberfeld P., Bolme P., Christensson B., Gahrton G., Hammarström L., Lefvert A. K., Lönnqvist B., Matell G. Myasthenia gravis after bone-marrow transplantation. Evidence for a donor origin. N Engl J Med. 1983 Dec 22;309(25):1565–1568. doi: 10.1056/NEJM198312223092508. [DOI] [PubMed] [Google Scholar]
  7. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  8. Truedsson L., Sturfelt G., Johansen P., Nived O., Thuresson B. Sharing of MHC haplotypes among patients with systemic lupus erythematosus from unrelated Caucasian multicase families: disease association with the extended haplotype [HLA-B8, SC01, DR17]. J Rheumatol. 1995 Oct;22(10):1852–1861. [PubMed] [Google Scholar]
  9. Yin J. A., Jowitt S. N. Resolution of immune-mediated diseases following allogeneic bone marrow transplantation for leukaemia. Bone Marrow Transplant. 1992 Jan;9(1):31–33. [PubMed] [Google Scholar]
  10. van Bekkum D. W. BMT in experimental autoimmune diseases. Bone Marrow Transplant. 1993 Mar;11(3):183–187. [PubMed] [Google Scholar]

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