title: Low incidence of transplant-related complications in patients with chronic release of tumor necrosis factor-alpha before admission to bone marrow transplantation: a clinical correlate of cytokine desensitization?
abstract: To investigate the role of tumor necrosis factor-alpha (TNF-alpha) released by activated macrophages, sequential serum samples of 120 patients undergoing bone marrow transplantation (BMT) were analyzed by enzyme-linked immunosorbent assay. De novo increases in serum TNF-alpha levels were correlated with the development of acute endothelial complications as well as acute graft-versus-host disease. In addition, the analysis of time courses revealed a different capacity of TNF-alpha regulation at various phases of BMT. While patients with acute TNF-alpha release in the first 2 weeks of BMT had a significantly enhanced incidence of complications, a subgroup of 9 patients with chronic asymptomatic release of TNF-alpha before admission to BMT was observed. These patients were protected from complications in the course of the first 6 months of BMT. Our observations indicate the occurrence of desensitization for TNF-alpha, as it is also reported after repeated injections of TNF-alpha or endotoxin in experimental models.
authors.affiliation: Institut für klinische Hämatologie der GSF.
authors.forename: E
authors.initials: E
authors.lastname: Holler
authors.forename: R
authors.initials: R
authors.lastname: Hintermeier-Knabe
authors.forename: H J
authors.initials: HJ
authors.lastname: Kolb
authors.forename: J
authors.initials: J
authors.lastname: Kempeni
authors.forename: A
authors.initials: A
authors.lastname: Möller
authors.forename: S
authors.initials: S
authors.lastname: Liesenfeld
authors.forename: L
authors.initials: L
authors.lastname: Daum
authors.forename: W
authors.initials: W
authors.lastname: Wilmanns
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology*; D016207:Cytokines / Q000276:immunology / Q000378:metabolism; D004351:Drug Resistance; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D007700:Kinetics; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology / Q000378:metabolism*
chemical_list: D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha