Blood, 1959, Vol. 14, No. 1, pp. 24-36.
© 1959 American Society of Hematology, Inc.
Studies on the Survival of Incompatible Cells in
Patients with Hypogammaglobulinemia
HUGH CHAPLIN JR. 1
1 Division of Hematology, Departments of Medicine and Preventive Medicine,
Washington University School of Medicine and the Barnes Hospital, Saint Louis, Mo.
1. Four adult patients are described whose sera showed a complete lack
of gamma globulin by paper electrophoresis.
2. All four patients might have been considered "universal recipients" because of the absence of isohemagglutinins on routine laboratory tests.
3. Weak isohemagglutinins were detectable in the sera from three of the
four subjects when the sensitivity of the in vitro test was increased.
4. Following intravenous administration of 4 ml. of ABO-incompatible cells,
red cell survival was shortened in all of the patients, with a wide range of
half-survival times from <10 minutes to as long as 9 days.
5. Although in vitro tests for antibody activity revealed no qualitative differences among the sera from the three patients with detectable isohemagglutinins, two different mechanisms of red cell removal were observed, one
which entailed nearly equal activity by both liver and spleen, the other being
primarily a function of the spleen.
6. The survival of incompatible cells under conditions of antibody "excess"
and antibody "insufficiency" was compared in one of the patients. The findings emphasize the sensitivity of in vivo survival studies employing small
volumes of incompatible cells to detect minute quantities of circulating antibody.
7. A fall in anti-A titer following the administration of group B cells to
one hypogammaglobulinemic subject is interpreted as a possible in vivo
example of the absorption of "cross-reacting" antibody in the ABO system.
8. In the light of the in vivo and in vitro findings, none of the 4 hypogammaglobulinemic patients in the present series could be categorized as "universal
recipients."
Submitted on March 10, 1958
Accepted on May 20, 1958
