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Antigen‐independent reactivation of anti‐E, years after allogeneic bone marrow transplantation: a case report

Summary. Nine years after allogeneic bone marrow transplantation a strong anti‐E was observed in a patient transplanted with bone marrow from his HLA‐identical brother. This IgG anti‐E, with a titre of 4000, was detected together with autoantibodies to red blood cells and platelets and was not induced by transfusion with E+ cells. The hypothesis is proposed that the anti‐E represents either antigen‐independent desuppression of the donor immune system sensitized at the time of bone marrow transplantation by E antigens in the recipient, or antigen‐independent memory B‐cell activation by Epstein‐Barr virus infection.