Nephrotic syndrome following allogeneic stem cell transplantation associated with increased production of TNF-alpha and interferon-gamma by donor T cells.

SUMMARY: Tumor necrosis factor-alpha (TNF-alpha) has been implicated in the immunological complications of stem cell transplantation (SCT) including graft-versus-host disease (GVHD). In this report of a patient undergoing allogeneic SCT for AML, serial cytokine measurements by real-time PCR revealed increased production of interferon-gamma (IFN-gamma) and TNF-alpha, but not interleukin (IL)-4 in purified T cells following withdrawal of immunosuppression. Cytokine changes were contemporaneous with the onset of nephrotic syndrome (NS), a rare manifestation of GVHD. These findings indicate that serial cytokine monitoring may allow for the prediction of GVHD during immunosuppression withdrawal and lend further insight into the pathogenesis of NS. Bone Marrow Transplantation (2003) 32, 447-450. doi:10.1038/sj.bmt.1704151