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May 19, 1989

Allergy and Immunology

JAMA. 1989;261(19):2824-2825. doi:10.1001/jama.1989.03420190100024

A study of 12 patients with hematologic cancer who underwent allogeneic transplantation of bone marrow whose donors had a history of atopy, revealed that allergen-specific IgE-mediated hypersensitivity was adoptively transferred.1 Thirty-six patients about to receive antithymocyte globulin (ATG) (pooled horse serum IgG) for bone marrow failure were prick tested with ATG. Of the 3 reacting positively, 2 received intravenous ATG. One of these died of anaphylaxis while the second was successfully desensitized. Bielory et al recommend prick testing all patients to be treated with heterologous antiserum samples, as positive intradermal tests did not predict anaphylaxis. Patients with positive reactions should be desensitized.2

Tumor infiltrating lymphocytes, derived from metastatic malignant melanoma tumors and expanded in vitro, and interleukin 2 were used to treat patients with metastatic melanoma. Twenty patients were treated by such adoptive transfer after receiving a single intravenous dose of cyclophosphamide. At least a 50% decrease in