Serum KL-6 levels in patients with pulmonary complications after allogeneic bone marrow transplantation.
KL-6, a mucinous high-molecular weight glycoprotein expressed on type 2 pneumocytes, has been shown to be elevated in the serum and bronchoalveolar lavage fluid of patients with interstitial pneumonitis (IP). We measured the serum levels of KL-6 in patients after they had undergone allogeneic bone marrow transplantation (BMT) to determine whether KL-6 could be a clinically useful indicator for the development of IP. The serum concentrations of KL-6 were determined by a sandwich-type enzyme-linked immunosorbent assay using an anti-KL-6 monoclonal antibody. A total of 1028 samples were tested from 76 patients (78 transplantations) who received BMTs. The KL-6 values were markedly elevated in patients with pulmonary complications, but not in those with acute and chronic graft-versus-host disease, hemorrhagic cystitis, herpes encephalitis, sepsis, and veno-occlusive disease. The serum levels of KL-6 from patients with pulmonary complications were significantly higher than from those without pulmonary complications (P < .001) and those with other complications (P < .001). Of the 12 patients with pulmonary complications, 6 had idiopathic IP (IIP). The levels were not high at the onset of IIP. Four of 6 IIP patients showed marked elevations of KL-6 levels in parallel with the severity of IP and died of respiratory failure without response to treatment. Assessment of serum KL-6 levels might not be useful for the early diagnosis of IP, but may be a useful indicator for monitoring the severity of IP after BMT.
Ashida
T
T
Third Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan. ashida@med.kindai.ac.jp
Higashishiba
M
M
Sumimoto
Y
Y
Sano
T
T
Miyazato
H
H
Shimada
T
T
Miyatake
J
J
Kawanishi
K
K
Tatsumi
Y
Y
Kanamaru
A
A
D000293:Adolescent; D000328:Adult; D000941:Antigens / Q000032:analysis / Q000097:blood*; D000951:Antigens, Neoplasm; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006023:Glycoproteins / Q000032:analysis / Q000097:blood*; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000378:metabolism; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D018396:Mucin-1; D009077:Mucins; D014184:Transplantation, Homologous / Q000009:adverse effects
D000941:Antigens; D000951:Antigens, Neoplasm; D015415:Biomarkers; D006023:Glycoproteins; C060192:MUC1 protein, human; D018396:Mucin-1; D009077:Mucins