Transfer of latent atopy by bone marrow transplantation? A case report

A previously healthy 8-year old girl was diagnosed with acute myelogenous leukemia, and, while she was in first remission, she received a bone marrow transplant from her atopic brother. Studies 1 to 2 years after transplantation revealed that the marrow recipient had a specific-IgE production of donor-type pattern, indicated by the similar skin prick test results and RAST scores in the donor and recipient demonstrating allergy to animal dander and house dust. The recipient's own immunity had been destroyed by the preparative regimen for marrow transplantation, and no lymphoid cells of host origin could be found after transplantation in the chromosome analysis. A sensitization of the recipient to animal dander after transplantation was very unlikely because no animal contacts were present, and the chronic liver graft-versus-host disease of the patient additionally suggested a delayed immunologic recovery. The case history suggests that atopy can be transferred by bone marrow transplantation from donor to recipient. A possible mechanism appears to be a passive transfer not only of lymphoid precursors but also of mature memory cells within the bone marrow inoculum. The donor memory B cells are presumably capable of starting specific-IgE production when the cells are stimulated in the host environment by factors still unknown.