Long-term observation of immunologic reconstitution after allogeneic bone marrow transplantation: differences in recovery among functional T cell subsets.

A 27-year-old male with acute lymphoblastic leukemia in the first relapse received allogeneic marrow graft from an HLA-identical sister on April 28, 1978. We studied in vitro immunologic parameters such as T cell surface phenotypes, proliferative response to PHA and Con A; T cell suppressor and helper function for in vitro immunoglobulin production stimulated with pokeweed mitogen serially after the transplantation. Despite a low OKT4/OKT8 ratio for more than 5 yrs after marrow grafting, proliferative response to PHA recovered to normal 4 yrs and 9 months post-transplant. In contrast, proliferative response to Con A did not recover. T cell suppressor function induced by Con A had recovered at 3 yrs 6 months; however helper T cell function took longer to recover. These findings suggest differences in functional recovery of T cell subsets following allogeneic marrow transplantation.