Table 1

Patients studied for transfer of allergy after hematopoietic stem cell transplantation

Source, patient no., demographics, diseaseDonorAllergy status*
Follow-upGVHDIS§ChimerismTransfer documented conclusively?
DonorPretransplantation recipientPosttransplantation recipient
Tucker et al29           
    1. 9 yo male; ALL HLA-ident. sib CM: eczema, rhinitis, asthma and angioedema/vomiting. Allergic to egg, fish, beans, and peanuts (by history) T-IgE: 1879 U/mLA-IgE: RAST 2 (egg), 4 (cat), 4 (DM), 3 (peanut) CM: noneT-IgE: 78 U/mLA-IgE: RAST 0 (egg), 0 (cat), 0 (DM), 0 (peanut) CM: angioedema/vomiting. Allergic to egg, ?fish, beans, and ?nuts (by history) T-IgE: 910 U/mLA-IgE: RAST 2 (egg), 4 (cat), 3 (DM), 3 (peanut) 25 mo Acute 6 mo NR Yes 
Saarinen27           
    2. 8 yo female; AML HLA-ident. sib CM: rhinitisT-IgE: NRA-IgE: RAST 3 (cat). SPT positive for cat, dog and DM CM: eczema “Allergic to egg” by history T-IgE: NRA-Ig: NR CM: indeterminate (frequent respiratory infections) T-IgE: 1300 U/mLA-IgE: RAST 2 (cat). SPT positive for cat, dog and DM. 3 y Acute 9 mo NR No** 
Walker et al30           
    3. 2 yo female; Morquio syndrome HLA-MM sib CM: noneT-IgE: 200 IU/mLA-IgE: RAST 1 (egg), 2 (cow's milk) CM: noneT-IgE: 41 IU/mLA-IgE: RAST 0 (egg), 0 (cow's milk) CM: noneT-IgE: >1000 IU/mLA-IgE: RAST 1 (egg), 0 (cow's milk) 26 mo NR NR NR No†† 
    4. 9 yo male; ALL HLA-ident. sib CM: eczema, asthma, angioedema/vomiting after ingesting nuts, beans, egg or fish. T-IgE = 840 IU/mLA-IgE = RAST 2 (cat), 1 (peanut), 3 (egg) CM: noneT-IgE: 9 IU/mLA-IgE: RAST 0 (cat), 0 (peanut), 0 (egg). CM: angioedema/vomiting after ingesting beans, egg or fish. T-IgE: 295 IU/mLA-IgE: RAST 3 (cat), 0 (peanut), 2 (egg) 13 mo NR NR NR Yes 
    5. 4 yo female; SAA HLA-ident. sib CM: rhinitis T-IgE: 900 IU/mLA-IgE: RAST 3 (Timothy) CM: none. T-IgE: <5 IU/mLA-IgE: RAST 0 (Timothy) CM: rhinitis. T-IgE: 200 IU/mLA-IgE: RAST 3 (Timothy) 24 mo NR NR NR Yes 
    6. 12 yo female; SAA HLA-ident. sib CM: “Intolerant” to penicillinT-IgE: 315 IU/mLA-IgE: RAST “positive” (penicillin V) CM: none (treated with penicillin without problems) T-IgE: >1000 IU/mLA-IgE: RAST “negative” (penicillin V) CM: rash when treated with azlocillin T-IgE: 80 IU/mLA-IgE: RAST “positive” (penicillin V) 3 mo NR NR NR Yes 
Bellou et al24           
    7. 5 yo male; ALL HLA-ident. sib CM: eczema, asthmaT-IgE: 285 IU/LA-IgE: 1.23 kU/L (egg). SPT positive for egg CM: noneT-IgE: NRA-IgE: NR CM: eczemaT-IgE: 6400 IU/LA-IgE: 65.00 kU/L (egg). SPT positive for egg 32 mo Acute 9 mo Complete No‡‡ 
Lucke et al25           
    8. 31 yo female; BLL HLA-ident. sib CM: eczema. Allergic to rubber by history and patch test T-IgE: NRA-IgE: NR CM: none T-IgE: NRA-IgE: NR CM: eczema. Allergic to rubber by history and patch test T-IgE: NRA-IgE: NR 8 mo Acute 8 mo Complete No§§ 
Rietz et al26           
    9. 18 yo female; AML HLA-ident. sib CM: asthma T-IgE: NRA-IgE: NR CM: none T-IgE: NRA-IgE: NR CM: asthma T-IgE: NRA-IgE: NR 32 mo NR NR NR No¶¶ 
    10. 43 yo female; AML HLA-ident. sib CM: Asthma T-IgE: NRA-IgE: NR CM: None T-IgE: NRA-IgE: NR CM: Asthma T-IgE: NRA-IgE: NR 6 mo NR NR NR No¶¶ 
Yong et al31           
    11. 41 yo female; NHL HLA-ident. sib CM: eczema, rhinitis and asthma. “Allergic to banana” by historyT-IgE: NRA-IgE: 32.70 kU/L (DM), 1.73 kU/L (dog), <0.35 kU/L (banana). SPT positive for DM, dog and pollens CM; noneT-IgE: 33 kU/LA-IgE <0.35 kU/L (banana), NR for DM or dog CM: eczema, rhinitis, urticaria/diarrhea after ingesting bananaT-IgE: 173 kU/LA-IgE: 1.45 kU/L (banana), NR for DM or dog. SPT positive for DM, dog and pollens 14 mo Acute 90 d Mixed (at 7 mo), then complete (after DLI) No‖‖ 
Agosty et al32 and Hallstrand et al33           
    12. 14 yo male; ALL HLA-ident. sib CM: moderate rhinitis and mild asthma T-IgE: NRA-IgE: RAST 4 (DF). SPT positive for DF CM: noneT-IgE: 17 U/mLA-IgE: RAST 0 (DF). SPT negative for DF CM: moderate rhinitis T-IgE: normal rangeA-IgE: RAST 3 (DF). SPT positive for DF 1 y None 6 mo Complete Yes 
    Same (later follow-up)    CM: mild asthma and moderate rhinitis. T-IgE: 731 U/mLA-IgE: RAST 1 (DF) 16 y None 6 mo Complete Yes 
    13. 43 yo male CML HLA-ident. sib CM: moderate rhinitis and mild asthma T-IgE: NRA-IgE: RAST 2 (DF). SPT positive for DF CM: moderate rhinitisT-IgE: <5U/mLA-IgE: RAST 0 (DF). SPT negative for DF CM: severe rhinitisT-IgE: normal rangeA-IgE: RAST 2 (DF). SPT positive for DF 1 y None 6 mo Complete No*** 
    Same (later follow-up)    CM: moderate rhinitis T-IgE: 839 U/mLA-IgE: RAST 4 (DF) 16 y None 6 mo Complete No*** 
    14. 38 yrs; Female; CML HLA-ident. sib CM: mild rhinitis. T-IgE: NRA-IgE: RAST 0 (DF) CM: noneT-IgE: 13U/mLA-IgE: RAST 0 (DF) CM: moderate rhinitis, moderate asthmaT-IgE: in normal rangeA-IgE: RAST 0 (DF) 1 yr None 6 mo Complete No††† 
    Same (later follow-up)    CM: severe asthma and moderate rhinitis T-IgE: 36 U/mLA-IgE: RAST 0 (DF) 16 yr Chronic ≤2yr Complete No††† 
    15. 47 yo male; CML HLA-ident. sib CM: mild rhinitis T-IgE: NRA-IgE: RAST 3 (DF). SPT positive for DF CM: none. T-IgE: 7 U/mLA-IgE: RAST 0 (DF). SPT negative for DF. CM: mild rhinitis T-IgE: normal rangeA-IgE: RAST 0 (DF). SPT negative for DF 1 y Acute 1 yr Complete No††† 
    Same (later follow-up)    CM: moderate rhinitis and moderate asthma T-IgE: 8 U/mLA-IgE: RAST 0 (DF) 14 y Chronic ≤2 yr Complete No††† 
    16. 17 yo female; AML HLA-ident. sib CM: moderate rhinitis, moderate asthma. T-IgE: NRA-IgE: RAST 0 (DF). CM: moderate rhinitis, moderate asthma T-IgE: 7 U/mLA-IgE: RAST 0 (DF). CM: moderate rhinitis, severe asthma T-IgE: normal rangeA-IgE: RAST 0 (DF) 1 y None 6 mo Complete No*** 
    Same (later follow-up)    CM: moderate rhinitis, moderate asthma T-IgE: 271 U/mLA-IgE: RAST 0 (DF). 15 y None 6 mo Complete No*** 
    17. 18 yo female; AML HLA-ident. sib CM: severe asthma T-IgE: NRA-IgE: RAST 2 (DF). SPT positive for DF. CM: none T-IgE: NRA-IgE: RAST 0 (DF). SPT negative for DF. CM: mild rhinitis T-IgE: normal rangeA-IgE: RAST 0 (DF). SPT positive for DF 1 y None 6 mo Complete No††† 
    18. 20 yo female; CML HLA-ident. sib CM: moderate rhinitis T-IgE: NRA-IgE: RAST 2 (DF). SPT positive for DF. CM: none T-IgE: NRA-IgE: RAST 0 (DF). SPT positive for DF. CM: mild rhinitis T-IgE: normal rangeA-IgE: RAST 0 (DF). SPT negative for DF. 1 y None 6 mo Complete No††† 
Source, patient no., demographics, diseaseDonorAllergy status*
Follow-upGVHDIS§ChimerismTransfer documented conclusively?
DonorPretransplantation recipientPosttransplantation recipient
Tucker et al29           
    1. 9 yo male; ALL HLA-ident. sib CM: eczema, rhinitis, asthma and angioedema/vomiting. Allergic to egg, fish, beans, and peanuts (by history) T-IgE: 1879 U/mLA-IgE: RAST 2 (egg), 4 (cat), 4 (DM), 3 (peanut) CM: noneT-IgE: 78 U/mLA-IgE: RAST 0 (egg), 0 (cat), 0 (DM), 0 (peanut) CM: angioedema/vomiting. Allergic to egg, ?fish, beans, and ?nuts (by history) T-IgE: 910 U/mLA-IgE: RAST 2 (egg), 4 (cat), 3 (DM), 3 (peanut) 25 mo Acute 6 mo NR Yes 
Saarinen27           
    2. 8 yo female; AML HLA-ident. sib CM: rhinitisT-IgE: NRA-IgE: RAST 3 (cat). SPT positive for cat, dog and DM CM: eczema “Allergic to egg” by history T-IgE: NRA-Ig: NR CM: indeterminate (frequent respiratory infections) T-IgE: 1300 U/mLA-IgE: RAST 2 (cat). SPT positive for cat, dog and DM. 3 y Acute 9 mo NR No** 
Walker et al30           
    3. 2 yo female; Morquio syndrome HLA-MM sib CM: noneT-IgE: 200 IU/mLA-IgE: RAST 1 (egg), 2 (cow's milk) CM: noneT-IgE: 41 IU/mLA-IgE: RAST 0 (egg), 0 (cow's milk) CM: noneT-IgE: >1000 IU/mLA-IgE: RAST 1 (egg), 0 (cow's milk) 26 mo NR NR NR No†† 
    4. 9 yo male; ALL HLA-ident. sib CM: eczema, asthma, angioedema/vomiting after ingesting nuts, beans, egg or fish. T-IgE = 840 IU/mLA-IgE = RAST 2 (cat), 1 (peanut), 3 (egg) CM: noneT-IgE: 9 IU/mLA-IgE: RAST 0 (cat), 0 (peanut), 0 (egg). CM: angioedema/vomiting after ingesting beans, egg or fish. T-IgE: 295 IU/mLA-IgE: RAST 3 (cat), 0 (peanut), 2 (egg) 13 mo NR NR NR Yes 
    5. 4 yo female; SAA HLA-ident. sib CM: rhinitis T-IgE: 900 IU/mLA-IgE: RAST 3 (Timothy) CM: none. T-IgE: <5 IU/mLA-IgE: RAST 0 (Timothy) CM: rhinitis. T-IgE: 200 IU/mLA-IgE: RAST 3 (Timothy) 24 mo NR NR NR Yes 
    6. 12 yo female; SAA HLA-ident. sib CM: “Intolerant” to penicillinT-IgE: 315 IU/mLA-IgE: RAST “positive” (penicillin V) CM: none (treated with penicillin without problems) T-IgE: >1000 IU/mLA-IgE: RAST “negative” (penicillin V) CM: rash when treated with azlocillin T-IgE: 80 IU/mLA-IgE: RAST “positive” (penicillin V) 3 mo NR NR NR Yes 
Bellou et al24           
    7. 5 yo male; ALL HLA-ident. sib CM: eczema, asthmaT-IgE: 285 IU/LA-IgE: 1.23 kU/L (egg). SPT positive for egg CM: noneT-IgE: NRA-IgE: NR CM: eczemaT-IgE: 6400 IU/LA-IgE: 65.00 kU/L (egg). SPT positive for egg 32 mo Acute 9 mo Complete No‡‡ 
Lucke et al25           
    8. 31 yo female; BLL HLA-ident. sib CM: eczema. Allergic to rubber by history and patch test T-IgE: NRA-IgE: NR CM: none T-IgE: NRA-IgE: NR CM: eczema. Allergic to rubber by history and patch test T-IgE: NRA-IgE: NR 8 mo Acute 8 mo Complete No§§ 
Rietz et al26           
    9. 18 yo female; AML HLA-ident. sib CM: asthma T-IgE: NRA-IgE: NR CM: none T-IgE: NRA-IgE: NR CM: asthma T-IgE: NRA-IgE: NR 32 mo NR NR NR No¶¶ 
    10. 43 yo female; AML HLA-ident. sib CM: Asthma T-IgE: NRA-IgE: NR CM: None T-IgE: NRA-IgE: NR CM: Asthma T-IgE: NRA-IgE: NR 6 mo NR NR NR No¶¶ 
Yong et al31           
    11. 41 yo female; NHL HLA-ident. sib CM: eczema, rhinitis and asthma. “Allergic to banana” by historyT-IgE: NRA-IgE: 32.70 kU/L (DM), 1.73 kU/L (dog), <0.35 kU/L (banana). SPT positive for DM, dog and pollens CM; noneT-IgE: 33 kU/LA-IgE <0.35 kU/L (banana), NR for DM or dog CM: eczema, rhinitis, urticaria/diarrhea after ingesting bananaT-IgE: 173 kU/LA-IgE: 1.45 kU/L (banana), NR for DM or dog. SPT positive for DM, dog and pollens 14 mo Acute 90 d Mixed (at 7 mo), then complete (after DLI) No‖‖ 
Agosty et al32 and Hallstrand et al33           
    12. 14 yo male; ALL HLA-ident. sib CM: moderate rhinitis and mild asthma T-IgE: NRA-IgE: RAST 4 (DF). SPT positive for DF CM: noneT-IgE: 17 U/mLA-IgE: RAST 0 (DF). SPT negative for DF CM: moderate rhinitis T-IgE: normal rangeA-IgE: RAST 3 (DF). SPT positive for DF 1 y None 6 mo Complete Yes 
    Same (later follow-up)    CM: mild asthma and moderate rhinitis. T-IgE: 731 U/mLA-IgE: RAST 1 (DF) 16 y None 6 mo Complete Yes 
    13. 43 yo male CML HLA-ident. sib CM: moderate rhinitis and mild asthma T-IgE: NRA-IgE: RAST 2 (DF). SPT positive for DF CM: moderate rhinitisT-IgE: <5U/mLA-IgE: RAST 0 (DF). SPT negative for DF CM: severe rhinitisT-IgE: normal rangeA-IgE: RAST 2 (DF). SPT positive for DF 1 y None 6 mo Complete No*** 
    Same (later follow-up)    CM: moderate rhinitis T-IgE: 839 U/mLA-IgE: RAST 4 (DF) 16 y None 6 mo Complete No*** 
    14. 38 yrs; Female; CML HLA-ident. sib CM: mild rhinitis. T-IgE: NRA-IgE: RAST 0 (DF) CM: noneT-IgE: 13U/mLA-IgE: RAST 0 (DF) CM: moderate rhinitis, moderate asthmaT-IgE: in normal rangeA-IgE: RAST 0 (DF) 1 yr None 6 mo Complete No††† 
    Same (later follow-up)    CM: severe asthma and moderate rhinitis T-IgE: 36 U/mLA-IgE: RAST 0 (DF) 16 yr Chronic ≤2yr Complete No††† 
    15. 47 yo male; CML HLA-ident. sib CM: mild rhinitis T-IgE: NRA-IgE: RAST 3 (DF). SPT positive for DF CM: none. T-IgE: 7 U/mLA-IgE: RAST 0 (DF). SPT negative for DF. CM: mild rhinitis T-IgE: normal rangeA-IgE: RAST 0 (DF). SPT negative for DF 1 y Acute 1 yr Complete No††† 
    Same (later follow-up)    CM: moderate rhinitis and moderate asthma T-IgE: 8 U/mLA-IgE: RAST 0 (DF) 14 y Chronic ≤2 yr Complete No††† 
    16. 17 yo female; AML HLA-ident. sib CM: moderate rhinitis, moderate asthma. T-IgE: NRA-IgE: RAST 0 (DF). CM: moderate rhinitis, moderate asthma T-IgE: 7 U/mLA-IgE: RAST 0 (DF). CM: moderate rhinitis, severe asthma T-IgE: normal rangeA-IgE: RAST 0 (DF) 1 y None 6 mo Complete No*** 
    Same (later follow-up)    CM: moderate rhinitis, moderate asthma T-IgE: 271 U/mLA-IgE: RAST 0 (DF). 15 y None 6 mo Complete No*** 
    17. 18 yo female; AML HLA-ident. sib CM: severe asthma T-IgE: NRA-IgE: RAST 2 (DF). SPT positive for DF. CM: none T-IgE: NRA-IgE: RAST 0 (DF). SPT negative for DF. CM: mild rhinitis T-IgE: normal rangeA-IgE: RAST 0 (DF). SPT positive for DF 1 y None 6 mo Complete No††† 
    18. 20 yo female; CML HLA-ident. sib CM: moderate rhinitis T-IgE: NRA-IgE: RAST 2 (DF). SPT positive for DF. CM: none T-IgE: NRA-IgE: RAST 0 (DF). SPT positive for DF. CM: mild rhinitis T-IgE: normal rangeA-IgE: RAST 0 (DF). SPT negative for DF. 1 y None 6 mo Complete No††† 

NR indicates not reported; yo, years old; SPT, skin prick test; HLA-MM, human leukocyte antigen mismatched; DM, dust mite (species not specified); DF, Dermatophagoids farinae; DLI, donor lymphocyte infusion; RAST, radio allergosorbent test; CML, chronic myelogenous leukemia; AML, acute myelogenous leukemia; ALL, acute lymphoblastic leukemia; NHL, non-Hodgkin lymphoma; CM, clinical manifestation; T-IgE, total IgE; and A-IgE, allergen-specific IgE.

*

Total serum IgE (suggestive but not diagnostic of allergy), typical reference value less than 300 IU/mL.

Allergen-specific IgE (diagnostic of allergic disease if present in a person with clinical manifestations of allergic disease). Typical reference value is less than 0.35 kU/L or RAST score 0 (scale 0-4).

Allergy status evalution was done at multiple time points after transplantation, however, the data shown in the table is for the time point when most prominent allergic reactions were observed or, if the timing of the allergic symptoms was not reported, the latest posttransplantation time point available.

§

Duration of pharmacologic immunosuppression

Agosti et al32 : only patients for whom patient-individual data have been reported are shown here.

Hallstrand et al33 : only patients for whom patient-individual data have been reported are shown here.

**

Patient 2: The recipient pretransplantation had eczema, recipient allergen-specific IgE pretransplantation was not reported; and presence or absence of clinical rhinitis or asthma posttransplantation could not be determined as the recipient had frequent respiratory infection.

††

Patient 3: transfer of allergy but not allergic disease.

‡‡

Patient7: pretransplantation allergen-specific IgE in the recipient was not studied.

§§

Patient 8: no patch test or allergen-specific IgE result on the recipient pretransplantation was reported.

¶¶

Patients 9 and 10: allergen-specific IgE was not studied.

‖‖

Patient 11: the donor had elevated IgE to dog, dust mite, and pollens but not banana, but the recipient posttransplantation had elevated IgE to dog, dust mite, pollens, and banana; recipient pretransplantation levels of IgE to dog, dust mite, and pollens were unreported, but he was known to have an elevated level of IgE to banana (so the allergy to banana could be of recipient origin).

***

Patients 13 and 16: recipient pretransplantation had rhinitis and/or asthma.

†††

Patients 14, 15, 17, 18: unclear whether allergic or nonallergic asthma/rhinitis was transferred; also, patient 18 had positive SPT for dust mite pretransplantation.

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