PURPOSE: Acute graft-versus-host disease (GvHD) is a constant and severe complication after allogeneic stem cell transplantation regularly involving skin, liver, gut, and lungs. The cytokine interleukin-18 (IL-18) has been shown to increase in patients who develop acute GvHD after bone marrow tranplantation (BMT). MATERIALS AND METHODS: Here, we measured IL-18 serum levels after peripheral blood stem cell transplantation (PBSCT) at several characteristic time points in 24 patients (median age 46 years). Patients received a median of 7.3 x 10(6)/kg bodyweight CD34-positive blood stem cells from HLA-matched family donors (n = 5), matched unrelated donors (n = 18), and one mismatched unrelated donor. GvHD prophylaxis consisted of cyclosporin A alone or combined with methotrexate and/or mycophenolate mofetil. RESULTS: In 14 patients we observed no GvHD or only GvHD grade I whereas ten patients developed GvHD grade II-IV post transplant. Low, intermediate, and high levels of serum IL-18 were found in patients after allogeneic PBSCT independently of GvHD after transplantation. In contrast to GvHD arising after BMT, there was no clear correlation between absolute IL-18 serum levels and GvHD grade after PBSCT. However, the individual time course of IL-18 serum level after engraftment correlates with acute GvHD after PBSCT. In detail, an increase of serum IL-18 of at least 1.6-fold after engraftment is associated with acute GvHD II or higher with a sensitivity of three out of four. Using the 1.6 "cut-off" for IL-18 increase after engraftment, a specificity of up to 100% can be achieved. CONCLUSION: The time course of IL-18 serum levels might be used for GvHD prediction after PBSCT comparable to absolute serum levels after BMT.
PURPOSE: Acute graft-versus-host disease (GvHD) is a constant and severe complication after allogeneic stem cell transplantation regularly involving skin, liver, gut, and lungs. The cytokine interleukin-18 (IL-18) has been shown to increase in patients who develop acute GvHD after bone marrow tranplantation (BMT). MATERIALS AND METHODS: Here, we measured IL-18 serum levels after peripheral blood stem cell transplantation (PBSCT) at several characteristic time points in 24 patients (median age 46 years). Patients received a median of 7.3 x 10(6)/kg bodyweight CD34-positive blood stem cells from HLA-matched family donors (n = 5), matched unrelated donors (n = 18), and one mismatched unrelated donor. GvHD prophylaxis consisted of cyclosporin A alone or combined with methotrexate and/or mycophenolate mofetil. RESULTS: In 14 patients we observed no GvHD or only GvHD grade I whereas ten patients developed GvHD grade II-IV post transplant. Low, intermediate, and high levels of serum IL-18 were found in patients after allogeneic PBSCT independently of GvHD after transplantation. In contrast to GvHD arising after BMT, there was no clear correlation between absolute IL-18 serum levels and GvHD grade after PBSCT. However, the individual time course of IL-18 serum level after engraftment correlates with acute GvHD after PBSCT. In detail, an increase of serum IL-18 of at least 1.6-fold after engraftment is associated with acute GvHD II or higher with a sensitivity of three out of four. Using the 1.6 "cut-off" for IL-18 increase after engraftment, a specificity of up to 100% can be achieved. CONCLUSION: The time course of IL-18 serum levels might be used for GvHD prediction after PBSCT comparable to absolute serum levels after BMT.
Authors: B Bonnotte; A M Burdiles; J Chehimi; G Carayol; C Pardoux; P Y Dietrich; M Kubin; J Y Blay; A Caignard; A Ibrahim; E Robinet; M Hayat; J L Pico; J H Bourhis; S Chouaib Journal: Eur Cytokine Netw Date: 1996-09 Impact factor: 2.737
Authors: H Itoi; Y Fujimori; H Tsutsui; K Matsui; S Futatsugi; H Okamura; H Hara; T Hada; E Kakishita; K Nakanishi Journal: Blood Date: 2001-07-01 Impact factor: 22.113
Authors: Y Aizawa; K Akita; M Taniai; K Torigoe; T Mori; Y Nishida; S Ushio; Y Nukada; T Tanimoto; H Ikegami; M Ikeda; M Kurimoto Journal: FEBS Lett Date: 1999-02-26 Impact factor: 4.124
Authors: H Glucksberg; R Storb; A Fefer; C D Buckner; P E Neiman; R A Clift; K G Lerner; E D Thomas Journal: Transplantation Date: 1974-10 Impact factor: 4.939
Authors: Y Gu; K Kuida; H Tsutsui; G Ku; K Hsiao; M A Fleming; N Hayashi; K Higashino; H Okamura; K Nakanishi; M Kurimoto; T Tanimoto; R A Flavell; V Sato; M W Harding; D J Livingston; M S Su Journal: Science Date: 1997-01-10 Impact factor: 47.728
Authors: Mary E D Flowers; Pablo M Parker; Laura J Johnston; Alice V B Matos; Barry Storer; William I Bensinger; Rainer Storb; Frederick R Appelbaum; Stephen J Forman; Karl G Blume; Paul J Martin Journal: Blood Date: 2002-07-15 Impact factor: 22.113