Is Type 1 Diabetes Transmissible by Bone Marrow Allograft?

A review of the medical literature suggests that type 1 diabetes in a bone marrow allograft donor may be transmitted to the recipient after a successful transplant (1,2). We report a 21-year follow-up after a successful allograft for aplastic anemia. The donor had type 1 diabetes at the time of transplant. The recipient has developed a number of antibodies against pancreatic islet cells, and although these have persisted for a number of years, she has not developed diabetes.

A 6-year-old Caucasian girl presented in 1976 with aplastic anemia. She showed a partial response to androgens, but this was not sustained, and in 1979 she received a bone marrow transplant (BMT) from her HLA-matched male sibling, who was 3 years older and had been diagnosed with type 1 diabetes 7 years earlier. Both patients were group O Rh (D) positive and HLA-A1, -2, -B8, and MLC nonreactive. The transplant procedure and the progress post-BMT have already been published (3). Full donor engraftment of the hemopoietic system has been documented on a number of occasions over the past 21 years. …