Rejection of bone-marrow graft by recipient-derived cytotoxic T lymphocytes against minor histocompatibility antigens

Lancet. 1990 Jan 20;335(8682):131-4. doi: 10.1016/0140-6736(90)90003-n.


A female patient showed rejection of a T-lymphocyte-depleted bone-marrow graft from her phenotypically HLA-identical father. Before bone-marrow transplantation, there was strong recipient anti-donor cellular cytotoxic reactivity directed against several minor histocompatibility (mH) antigens, including the male-specific H-Y antigen. After conditioning treatment, no recipient anti-donor cytotoxic activity could be detected, and good graft function was shown a month after transplantation. Thereafter, however, graft function deteriorated rapidly, while recipient-derived anti-donor cellular cytotoxic reactivity, against similar mH antigens, reappeared. The recipient-derived cytotoxic T lymphocytes could completely inhibit growth of donor haemopoietic progenitor cells both before and after bone-marrow transplantation. Thus, cytotoxic T lymphocytes can survive very intensive conditioning regimens, and residual recipient cytotoxic T lymphocytes directed against mH antigens expressed on donor haemopoietic progenitor cells may cause graft rejection after HLA-identical T-lymphocyte-depleted bone-marrow transplantation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Marrow Transplantation / methods*
  • Cell Line
  • Chromosome Mapping
  • Evaluation Studies as Topic
  • Female
  • Graft Rejection / immunology*
  • H-Y Antigen / analysis
  • HLA Antigens / immunology*
  • Hematopoietic Stem Cells / immunology
  • Humans
  • Lymphocyte Depletion
  • Male
  • Metaphase
  • Myelodysplastic Syndromes / surgery*
  • Phenotype
  • T-Lymphocytes, Cytotoxic / cytology
  • T-Lymphocytes, Cytotoxic / physiology*
  • Time Factors
  • Transplantation Immunology


  • H-Y Antigen
  • HLA Antigens