ABSTRACT

I.INTRODUCTION Transfusion-inducedgraft-versus-hostdisease(TI-GVHD)isapotentialcomplicationofany bloodtransfusionwhenacomponentcontainingviableimmunocompetentlymphocytesis transfusedintoarecipientwhoisincapableofeffectivelyresistingengraftment.Implicated componentsincludewholebloodandpackedredbloodcells(RBCs)(1-8),plateletconcentrates (9,10),granulocytesfromnormaldonors(9,11-17),granulocytesfromchronicmyelogenous leukemia(CML)donors(18-19),freshplasma(1,20-24),andevenpreviouslyfrozen, deglycerolizedRBCs(25,26)aloneorincombinations(9,19,27-29).ReviewersofTI-GVHD priorto1990(30-40)suggestedthatimmunosuppressionorimmuneincompetencyofthe recipientwasanecessaryantecedentforTI-GVHD.However,recentreportsofTI-GVHDin personswithnoapparentimmuneincompetency(17,41-78)raisesuspicionabouttheabsolute requirementforrecipientimmunocompromise(79-82).ThereportsofGVHDaftersyngeneic andautologousbonemarrowtransplantation(83)areprobablydifferentfromTI-GVHDbecause offunctionalimmunosuppressionduetochemotherapywithorwithoutirradiation.Therehave beenatleast65recentreports(notincludingabstracts)publishedinEnglishofrecipientswho havedevelopedTI-GVHD(Table1).