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1993 Fiscal Year Final Research Report Summary

Study on diagnosis developmental mechanism of transfusion-associated GVHD by analysis of DNA polymorphism

Research Project

Project/Area Number 04454315
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field General surgery
Research InstitutionKYOTO UNIVERSITY

Principal Investigator

ITO Kazuhiko  Kyoto University Hospital, Department of Transfusion Medicine, Professor, 医学部, 教授 (50034640)

Co-Investigator(Kenkyū-buntansha) YOSHIDA Hisahiro  Kyoto University Hospital, Department of Transfusion Medicine, Instructor, 医学部, 助手 (30135587)
Project Period (FY) 1992 – 1993
KeywordsTransfusion-associated GVHD (TA-GVHD) / Immunodeficiency / HLA homozygote / HLA heterozygote / Chimera / DNA polymorphism / Transfusion / Microsatellite gene
Research Abstract

Transfusion-associated GVHD (TA-GVHD) develops in immunocompromized and immmunocompetent patients. When a recipient of HLA hetrozygote (a/b) is transfused with blood from a donor of HLA homozygote (a/a), a/b recognizes a/a as self and does not reject it but a/a recognizes a/b as nonself and damages it. Such a combination occurs 1/900 among unrelated Japanese and 1/100 between Japanese parents and children because the Japanese are relatively genetically homogeneous. However, the number of cases reported as TA-GVHD is lower than the estimated values. There is a possibility that patients with TA-GVHD have not been diagnozed truly and were overlooked. A new useful method for the diagnosis of TA-GVHD is DNA polymorphism detected by the length of microsatellite genes. DNA polymorphism of a patient's circulating lymphocytes is compared with that of his nail which is clearly his own self.
Case 1 developed the typical symptoms of TA-GVHD after surgery of A-C bypass of heart with blood transfusion. Chimera was demonstrated in DNA polymorphism. Case 2 of acute promyerocytic leukemia was transfused frequently, developed doubtful symptoms of TA-GVHD and died. Change of DNA polymorphism was not demonstrated by repeated examination with circulating lymphocytes. Nail was not available. Case 3 developed doubtful symptoms of TA-GVHD after delivery with blood transfusion for bleeding. Chimera was not demonstrated in DNA polymorphism. The HLA phenotype of circulating lymphocytes was heterozygous. TA-GVHD was denied. The patient got well. Case 4 developed the typical symptoms of TA-GVHD after surgery of cystic cancer with blood transfusion. Chimera was not demonstrated in DNA polymorphism. The HLA phenotype of circulating lymphocytes was heterozygous. The symptom disappeared gradually after postperative day 14. The patient got well. The symptom may be due to drug allergy.
Examination of DNA polymorphism is a strong means for the diagnosis of TA-GVHD.

  • Research Products

    (2 results)

All Other

All Publications (2 results)

  • [Publications] 岡垣哲弥,伊藤和彦: "輸血後GVHDの臨床" 日本輸血学会雑誌. 40. 524-527 (1994)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Tetsuya Okagaki and Kazuhiko Ito: "Clinical aspect of transfusion-associated GVHD" Japanese Journal of Transfusion Medicine. 40 (3). 524-527 (1994)

    • Description
      「研究成果報告書概要(欧文)」より

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Published: 1996-04-15  

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