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Adverse effects of intradermal allogeneic lymphocyte immunotherapy: acute reactions and role of autoimmunity.

Kling C, Steinmann J, Westphal E, Magez J, Kabelitz D

Institute of Immunology, University Hospital of Schleswig-Holstein, Campus Kiel, Michaelisstr. 5, D-24105 Kiel, Germany.

BACKGROUND: Immunotherapy with allogeneic lymphocytes was introduced as a therapeutic option for selected infertile couples in different centres worldwide 20 years ago. It has been suggested for other indications as well, e.g. for pregnant women at risk of a child with Rhesus-D haemolytic disease, or as a vaccine which might reduce the receptiveness for HIV-1 infection. Here we report on our experience on adverse side-effects of intradermal lymphocyte immunotherapy (LIT) for infertile couples using partner's lymphocytes. METHODS: Prospective 4 week follow-up of all couples from 2000 to 2003 for acute reactions (feedback 2587/3246, 83%). All couples treated between 1996 and 2002 received questionnaires after 2-3 years (feedback 1914/3041, 63%). RESULTS: Local reactions predominantly consisted of redness and itching for approximately 2 weeks. Systemic reactions could be attributed to LIT in 6-8%. Blisters at the injection sites were characteristic of LIT but not dependent on the HLA class I mismatch status between cell donor and host. The incidence of autoimmune disease was 0.1%. Four patients developed thromboembolism in pregnancy which was not ascribed to antiphospholipid syndrome. CONCLUSIONS: Acute side-effects are comparable to those reported after intradermal vaccination for infectious diseases. Specific risks for anaphylaxis, autoimmune or graft versus host disease were not detected.

Published 20 January 2006 in Hum Reprod, 21(2): 429-35.
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Blood Transfusion Books

A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship (Studies in Social Medicine)

A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship (Studies in Social Medicine)