Prospective monitoring of tumor necrosis factor alpha and interferon gamma to predict the onset of acute and chronic graft-versus-host disease after allogeneic stem cell transplantation.
Peripheral blood T cells were isolated from 19 allogeneic and 4 autologous stem cell transplant (SCT) recipients and assessed for tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma transcription by reverse transcription-polymerase chain reaction. Levels were compared with resting donor T-cell transcription levels. Increased production of TNF-alpha predicted for the onset of severe (grade II-IV) graft-versus-host disease (GVHD) (P = .001). Increased TNF-alpha (P = .025) and IFN-gamma (P = .001) transcription also independently predicted for the eventual onset of extensive chronic GVHD. Increased TNF-alpha or IFN-gamma transcription was not seen in either a syngeneic SCT recipient or 4 autologous SCT controls. These findings provide a means by which GVHD can be predicted before it is clinically evident, thus allowing for accurate diagnosis and monitoring of GVHD and possibly more cost-effective management of post-SCT immunosuppression.
Ritchie
David
D
Malaghan Institute of Medical Research, Wellington, New Zealand. david.ritchie@petermac.org
Seconi
Janet
J
Wood
Catherine
C
Walton
Julie
J
Watt
Victoria
V
D000208:Acute Disease; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000378:metabolism* / Q000628:therapy; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007371:Interferon-gamma / Q000096:biosynthesis*; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D036102:Peripheral Blood Stem Cell Transplantation; D011237:Predictive Value of Tests; D012333:RNA, Messenger / Q000096:biosynthesis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*
D015415:Biomarkers; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma