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Mosquito allergy: a novel strong prognostic symptom of outcome after allogeneic hematopoietic transplantation

Bone Marrow Transplantation volume 55, pages 1509–1511 (2020)Cite this article

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Reactions to mosquito bites are generally considered to be allergic reactions to mosquito saliva. However, in healthy adults, severe allergic reactions (mosquito allergy) are suppressed by desensitization or immune tolerance. Severe reactions to mosquito bites have also been reported in pediatric and immunocompromised patients. Moreover, mosquito allergy is a well-known characteristic symptom of Epstein–Barr virus-associated lymphoproliferative disorders (EBV-LPD) [1,2,3]. Although this phenomenon tends to be overlooked, we have encountered patients showing mosquito allergy after allogeneic hematopoietic cell transplantation (allo-HCT). However, its implications on the immunological background and its effect on prognosis remain unknown. Therefore, in this prospective observational study, we comprehensively investigated the prognosis and immune profile of patients who had mosquito allergy after allo-HCT.

We evaluated the prevalence of mosquito allergy in transplant patients who visited the Osaka City University Hospital outpatient clinic between September 2012 and March 2017, both before and after they received allo-HCT. Each follow-up was conducted for at least 1 year after each survey to evaluate the outcome prospectively. In addition, peripheral blood was collected in patients who stopped taking immunosuppressive drugs and steroids 1 year or more after transplantation. We then analyzed the peripheral blood mononuclear cells’ EBV DNA level, total IgE (radioimmunosorbent test [RIST]), antigen-specific IgE (radioallergosorbent test [RAST]), and the profile of peripheral blood immunocompetent cells by using multicolor flow cytometry. This study was approved by the Committee of Ethics at Osaka City University, and written informed consent was obtained from all patients.

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Acknowledgements

This work was supported by JSPS (Japanese Society for the Promotion of Science) KAKENHI Grant Number JP17K09017.

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  1. Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan

    Shiro Koh, Hirohisa Nakamae, Satoru Nanno, Takahiko Nakane, Yasuhiro Nakashima, Hideo Koh, Mika Nakamae, Asao Hirose & Masayuki Hino

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  1. Shiro Koh
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Correspondence to Hirohisa Nakamae.

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HN and MH received funds to institution from MSD K.K.

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Koh, S., Nakamae, H., Nanno, S. et al. Mosquito allergy: a novel strong prognostic symptom of outcome after allogeneic hematopoietic transplantation. Bone Marrow Transplant 55, 1509–1511 (2020). https://doi.org/10.1038/s41409-019-0759-y

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