Acute adverse effects of allogeneic lymphocyte immunization

Purpose: For some women with recurrent first trimester abortions or repeated implantation failure during an IVF/ICSI-program lymphocyte i.c. immunization therapy (LIT) with partner-derived lymphocytes is a therapeutic option. Here we describe the acute symptoms which can occur after LIT. Materials and Methods: A prospective 4 week follow-up of all couples who underwent LIT from 2000 to 2003 for acute local and systemic side effects (feedback 2587/3246=83% of treatments) was carried out. Data raised in another survey (first LIT 1996 - 2002, feedback 1914/3041 = 63% of the couples) are included. Results: After LIT, local reactions were slightly stronger than those reported after i.c. vaccination. After the first LIT they were significantly more marked than after a subsequent LIT and also correlated positively with the number of injected cells. They subsided without abcess formation or scarring. Blistering at the injection sites seems to be specific for LIT and was reported by 6 14% of the patients but was not influenced by the HLA class I matching between patient and donor. Systemic reactions were equivalent to those occurring after vaccination. 14 of 2587 LIT treatments (0.5%) were accompanied by various forms of rashes; in 10 cases these were unexplained and possibly caused by LIT. We did not recognize specific risks of anaphylaxis, autoimmune or graft versus host disease (GvDH). Conclusion: Local and systemic reactions after i.c. LIT are comparable to those reported after i.c. vaccination and self-limiting.