Serum
IgA levels were monitored at 3, 6, 12, and 24 months after BMT in 131 allogeneic and 3 syngeneic bone marrow transplant recipients. In general,
IgA levels were low during the first 6 months and did not return to normal levels until 1-2 years after
transplantation. Children (less than 15 years) had lower
IgA levels at 3 and 6 months post-BMT compared to the adults (P less than 0.05), but donor age had no influence on the recipient
IgA levels after BMT. Patients receiving either
methotrexate or
cyclosporine alone for GVHD prophylaxis had markedly lower
IgA levels compared to those given a combination of these two drugs or patients transplanted with T-cell-depleted marrow (P less than 0.001). Mean
IgA levels in patients without or with grade I acute GVHD were within the normal range at 3, 6, 12, and 24 months after BMT (greater than 0.3 g/L), although approximately 20% of the patients in each group showed low
IgA levels (less than or equal to 0.3 g/L) early after
transplantation. Patients with grade II or III acute GVHD had significantly lower values from 3 months up to 2 years after
transplantation (P less than 0.01). Patients with chronic GVHD had significantly lower
IgA levels 1 and 2 years after BMT compared to patients without chronic GVHD (P less than 0.005). Severe acute GVHD, particularly when followed by chronic GVHD, seems to be the main reason for low
IgA levels, while other factors such as CMV
infection or donor status may also contribute to the development of
IgA deficiency after BMT.