The use of transfer factor in a patient with agammaglobulinemia

We have studied a 9-year-old boy with agammaglobulinemia treated for the past 6 years with exogenous gamma-globulin who was noted to have an immunoglobulin (Ig)M level of 35 mg/100 ml and circulating B cells as determined by immunofluorescence. Of the circulating lymphocytes, 41% had alpha-immunoglobulin heavy chains, 3% gamma chains, and 3% mu chains. Synthesis of gamma heavy chain classes showing wide heterogeneity and alpha and mu chains of restricted mobility was demonstrated by radioimmunoelectrophoresis. Because of the patient's poor clinical response to exogenous gamma-globulin administration and the paradoxic presence of circulating B cells, with the capacity to synthesize immunoglobulins in vitro, we elected to begin a course of therapy with transfer factor. After the initial four doses of transfer factor (2 x 10(8) lymphocytes/dose) his serum IgG rose from 50 to 130 mg/100 ml, the same level which he had previously attained during continuous exogenous gamma-globulin therapy. His serum IgG has remained at this level for the past 12 months with trimonthly booster doses of transfer factor. The patient has not required any additional gamma-globulin therapy and he has remained clinically asymptomatic. Our studies in a patient with agammaglobulinemia have shown that transfer factor therapy may affect immunoglobulin synthesis. The concurrent discontinuation of exogenous gamma-globulin administration makes it difficult to attribute the changes to only one or another aspect of therapy. We await further reports of the effects of transfer factor in the therapy of patients with B cell disorders.