An in Vitro Predictive Test for Graft versus Host Disease in Patients with Genotypic HLA-Identical Bone Marrow Transplants

Georgia B. Vogelsang, Allan D. Hess, Aron W. Berkman, Peter J. Tutschka, Evan R. Farmer, Paul Converse, George W. Santos

Research output: Contribution to journalArticlepeer-review

Abstract

Acute graft versus host disease remains a major cause of morbidity and mortality in allogeneic bone marrow transplantation. To date, no clinically useful test has been reported that will predict the occurrence of graft versus host disease in genotypic HLA-identical donor-recipient pairs. We have developed a skin-explant model using donor lymphocytes that have been sensitized against recipient lymphocytes in vitro and cocultured with the recipient's skin. Histologic changes compatible with acute graft versus host disease are found in the positive explants. To date 32 patients have been tested in a prospective manner. Among the 18 recipient-donor pairs that were positive, 16 patients were found to have histologic Grade 2 or higher graft versus host disease of the skin on biopsy. Among the 14 negative pairs, only 3 patients had histologic Grade 2 or higher graft versus host disease of the skin on biopsy. Thus, the model has a sensitivity of 84 per cent and a specificity of 85 per cent, and is a significant predictor of the histologic occurrence of graft versus host disease (P<0.0005 by chi-square test). The test may be useful in the selection of donors for bone marrow transplantation and in the planning of prophylaxis against graft versus host disease. (N Engl J Med 1985; 313:645–50.).

Original languageEnglish (US)
Pages (from-to)645-650
Number of pages6
JournalNew England Journal of Medicine
Volume313
Issue number11
DOIs
StatePublished - Sep 12 1985

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'An in Vitro Predictive Test for Graft versus Host Disease in Patients with Genotypic HLA-Identical Bone Marrow Transplants'. Together they form a unique fingerprint.

Cite this