Document 2829
 DOCN  M94A2829
 TI    Haplotype-matched peripheral blood mononuclear cell (PBMC) transfusions
       in patients with late-stage AIDS.
 DT    9412
 AU    Gomatos PJ; Reiter WM; Keller RH; Cimoch PJ; Vorce DE; Giannetti B;
       Uribe MR; Center for Special Immunology, Ft. Lauderdale, Florida.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):215 (abstract no. PB0290). Unique
       Identifier : AIDSLINE ICA10/94369746
 AB    OBJECTIVE: To determine the safety and tolerance of monthly transfusions
       of haplotype-matched, cross-matched PBMC's in patients with late-stage
       AIDS. METHODS: Patients with late-stage AIDS and history of multiple
       OI's or visceral KS received monthly transfusions of HIV hyperimmune
       plasma in which HIV was inactivated, followed by > 3 x 10(9)
       haplomatched, cross-matched PBMC's from an HIV negative donor. RESULTS:
       Sixteen patients, mean CD4 count 25 cells/mm3 at entry, were followed
       for an average of 4.1 months (range 1-7 months). During the treatment
       period, 7 remained stable (avg 6.1 transfusions), 1 withdrew after
       recovery from a TRALI reaction (1 transfusion), 3 withdrew for
       non-medical reasons (avg 1.7 transfusions) and 5 died (avg 3.2
       transfusions). Manifestations possibly representing GVHD included:
       flu-like symptoms occurring 3-5 days after cell transfusion and lasting
       2-5 days in all patients, sometimes with transient painful
       lymphadenopathy; episodes of watery diarrhea in 4; transient oral ulcers
       in 3; transient pruritic papular rash in 2 and an episode of hematemesis
       in 1 patient with chronic inflammation on GI biopsy, non-Hodgkins
       lymphoma and CMV colitis who was lost to follow-up and died from an
       unspecified cause. Remaining deaths were from OI's in 3 patients and
       neutropenia/sepsis in 1. Ten patients received 3 or more transfusions
       from the same donor (avg 5.6). Following 4 transfusions, 1 patient
       transiently developed an IgG antibody against donor T cell antigen,
       which subsequently cleared, allowing further transfusion from this
       donor. CONCLUSIONS: Repetitive transfusions of matched PBMC's in
       patients with late-stage AIDS were generally well-tolerated. In all but
       one subject with hematemesis, manifestations possibly representing GVHD
       were sporadic, mild and self-limited. Repetitive transfusions of cells
       from a single donor did not result in sustained sensitization in any
       recipient. An expanded phase I/II study has been initiated.
 DE    Acquired Immunodeficiency Syndrome/*THERAPY  Graft vs Host
       Disease/ETIOLOGY  Haplotypes/GENETICS  Hematemesis/ETIOLOGY
       Histocompatibility Testing  Human  Immunization  *Leukocyte
       Transfusion/ADVERSE EFFECTS  Leukocytes, Mononuclear/*TRANSPLANTATION
       Safety  Treatment Outcome  MEETING ABSTRACT

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