TRANSPLANTATION FOR SEVERE COMBINED IMMUNODEFICIENCY WITH HLA-A,B,D,DR INCOMPATIBLE PARENTAL MARROW-CELLS FRACTIONATED BY SOYBEAN AGGLUTININ AND SHEEP RED-BLOOD-CELLS

Abstract

Three patients with severe combined immunodeficiency (SCID) received transplants of HLA haplotype-mismatched parental bone marrow depleted of T lymphocytes by differential agglutination with soybean agglutinin (SBA) and subsequent E-rosette depletion. Two patients achieved durable engraftment with reconstitution of both humoral and cell-mediated immunity. Neither of these patients developed graft vs. host disease (GVHD). The 3rd patient achieved only a transient engraftment with concomitant development of mitogen-responsive lymphocytes of paternal origin. Depletion of T lymphocytes by this technique apparently can abrogate the potential of histoincompatible marrow grafts to induce lethal GVHD without limiting immunologic reconstitution. Nonimmune mechanisms of graft resistance may necessitate preparative treatment of patients with SCID before transplantation with HLA-mismatched marrow cells.