Serum TNFalpha levels in patients with acute graft-versus-host disease after bone marrow transplantation.

Tumor necrosis factor alpha (TNFalpha) has been implicated in the pathogenesis of graft-versus-host disease (GVHD). In this study, serum levels of TNFalpha were assessed by ELISA in 243 sera samples from 40 patients who had undergone allogeneic bone marrow transplantation (BMT). Serum TNFalpha levels were measured before BMT and at different time points after BMT. The results were correlated with acute GVHD (aGVHD), infection and conditioning regimen. Serum TNFalpha levels were significantly higher in patients with grades II-IV aGVHD than in those with grade 0 or I aGVHD, but there was no clear correlation between serum TNFalpha and severity of aGVHD. Serum TNFalpha levels in infected patients were not statistically different from those in patients without infection. The conditioning regimen did not cause a significant rise in TNFalpha levels. These results indicate that TNFalpha may be useful for the diagnosis of aGVHD and for differentiating between aGVHD and other BMT-related complications, such as infection.