Bone-marrow transplantation in severe combined immunodeficiency syndrome

Six sibling-to-patient allogeneic bone-marrow transplantations were carried out in three infants with the combined immunodeficiency syndrome. There was HL-A identity between two donor-recipient pair combinations and no detectable antigenic disparity in the third pair. Each recipient received at least one stem-cell enriched marrow which had been fractionated on a discontinuous albumin gradient in an attempt to avoid graft-versus-host disease. This technique prevented secondary disease but resulted in equipment with humoral immunity only in one patient. Cellular immunity was not restored either by this technique or by the implantation of fetal thymus. One patient, in whom gradient marrow failed, was restored to full cellular and humoral immunocompetence by the infusion of whole, unfractionated marrow.