1. Transfer and loss of allergen-specific responses via stem cell transplantation: A prospective observational study.
- Author
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Debiasi M, Pichler H, Klinglmüller F, Boztug H, Schmidthaler K, Rech J, Scherer D, Lupinek C, Valenta R, Kacinska-Pfaller E, Geyeregger R, Fritsch G, Haas OA, Peters C, Lion T, Akdis M, Matthes S, Akdis CA, Szépfalusi Z, and Eiwegger T
- Subjects
- Immunoglobulin E, Prospective Studies, Stem Cell Transplantation, Allergens, Hematopoietic Stem Cell Transplantation
- Abstract
Background: Currently, no estimates can be made on the impact of hematopoietic stem cell transplantation on allergy transfer or cure of the disease. By using component-resolved diagnosis, we prospectively investigated 50 donor-recipient pairs undergoing allogeneic stem cell transplantation. This allowed calculating the rate of transfer or maintenance of allergen-specific responses in the context of stem cell transplantation., Methods: Allergen-specific IgE and IgG to 156 allergens was measured pretransplantation in 50 donors and recipients and at 6, 12 and 24 months in recipients post-transplantation by allergen microarray. Based on a mixed effects model, we determined risks of transfer of allergen-specific IgE or IgG responses 24 months post-transplantation., Results: After undergoing stem cell transplantation, 94% of allergen-specific IgE responses were lost. Two years post-transplantation, recipients' allergen-specific IgE was significantly linked to the pretransplantation donor or recipient status. The estimated risk to transfer and maintain individual IgE responses to allergens by stem cell transplantation was 1.7% and 2.3%, respectively. Allergen-specific IgG, which served as a surrogate marker of maintaining protective IgG responses, was highly associated with the donor's (31.6%) or the recipient's (28%) pretransplantation response., Conclusion: Hematopoietic stem cell transplantation profoundly reduces allergen-specific IgE responses but also comes with a considerable risk to transfer allergen-specific immune responses. These findings facilitate clinical decision-making regarding allergic diseases in the context of hematopoietic stem cell transplantation. In addition, it provides prospective data to estimate the risk of transmitting allergen-specific responses via hematopoietic stem cell transplantation., (© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)
- Published
- 2020
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