Allotype Analysis to Distinguish the Origin of Varicella-Zoster Virus Immunoglobulin G after Allogeneic Stem Cell Transplantation

Rie Yamazaki, Hideki Nakasone, Yukie Tanaka, Miki Sato, Kiriko Terasako, Hidenori Wada, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Masahiro Ashizawa, Tomohito Machishima, Shun ichi Kimura, Misato Kikuchi, Shinya Okuda, Shinichi Kako, Junya Kanda, Aki Tanihara, Junji Nishida, Yoshinobu Kanda

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2 Citations (Scopus)


Varicella-zoster virus (VZV) reactivation is a frequent complication after allogeneic hematopoietic stem cell transplantation (HSCT). Although previous studies have revealed that cellular immunity is important for suppressing reactivation, the role of humoral immunity against VZV has been poorly evaluated. We analyzed inherited polymorphisms in the immunoglobulin G (IgG) heavy chain constant regions of 50 HSCT recipient-donor pairs to distinguish donor-derived and recipient-derived antibodies. Twelve pairs were informative regarding the origin of IgG, since either the donors (n= 3) or recipients (n= 9) were homozygous null for the IgG1m(f) allotype. In these 9 homozygous-null recipients, allotype-specific IgG against VZV were measured by enzyme-linked immunosorbent assay and compared with measles-IgG. All 9 homozygous-null recipients were monitored for more than 1 year after HSCT, with (n= 4, localized zoster) or without (n= 5) clinical VZV disease. In 3 patients with VZV disease, donor-derived IgG against VZV was elevated between 500 to 700 days after HSCT after the episode of VZV disease. In 1 patient who suffered from VZV disease just before HSCT, donor-derived VZV IgG was elevated within 3 months after HSCT. On the other hand, 2 patients who received reduced-intensity conditioning (RIC) transplantation from an IgG1m(f) null donor maintained recipient-derived IgG against VZV for more than 1 year, whereas it was decreased within 3 months in 1 recipient who received conventional conditioning. In conclusion, the production of anti-VZV IgG by recipient plasma cells persists long after RIC. In patients without symptomatic VZV reactivation, donor-derived anti-VZV IgG did not reach titers comparable to those measured in healthy virus carriers.

Original languageEnglish
Pages (from-to)1013-1020
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Issue number7
Publication statusPublished - 2013 Jul
Externally publishedYes


  • Allogeneic stem cell transplantation
  • Humoral immunity
  • Immunoglobulin G allotype
  • Varicella-Zoster virus

ASJC Scopus subject areas

  • Hematology
  • Transplantation


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