Enhanced graft-versus-host disease in older recipient mice following allogeneic bone marrow transplantation

The incidence and severity of GVHD following bone marrow transplantation increases with recipient age. The role of recipient age on the development of GVHD was analyzed in a semi-allogeneic (C57B/6 → (C57BL/6 x DBA/2)F1) murine GVHD system. Young adult (2 months) and old (12-14 months) recipient mice were lethally irradiated and reconstituted with young adult T cell-depleted bone marrow (ATBM) or ATBM and young spleen cells. A significantly higher percentage of old vs young recipients developed lethal GVHD. Furthermore, while pre-transplant conditioning with irradiation was not required to observe increased mortality in old recipients, irradiation predisposed the older animals for a more severe course of GVHD, suggesting that GVHD occurred in old compared to young animals in the absence of pre-transplant conditioning but was exacerbated by irradiation. Histologically, the immunological responses in the GVHD target organs were more severe in the old GVHD animals. In support of this observation, increased spontaneous proliferation was observed using lymphoid cells isolated from old vs young GVHD mice. These findings demonstrate that old recipients develop a more severe course of GVHD following BMT, and may present a unique opportunity to study age-related factors in the generation of GVHD.