Discrimination of acute graft-versus-host disease from infections by enumeration of peripheral blood interferon-gamma spot-forming cells.
Infections may coexist and in certain circumstances aggravate acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation. Early detection of aGVHD is often difficult in patients with concurrent infections. Using an enzyme-linked immunospot assay that reflects ongoing immune status in vivo, we enumerated spot-forming cells (SFCs) for interferon (IFN)-gamma, interleukin (IL)-4, and IL-12 in peripheral blood from 56 patients with hematological disorders. Eleven patients had viral, fungal, or bacterial systemic infections during first 10 weeks posttransplant. Of these, six patients with grade 0-I aGVHD showed normal levels of IFN-gamma SFCs. On the other hand, IFN-gamma SFCs were elevated in five patients with grade II-IV aGVHD. These data indicate that increased IFN-gamma SFCs seemed to be correlated with clinically significant aGVHD, but not with infection itself. IL-4 and IL-12 SFCs increased in some patients with infections, irrespective of the presence of aGVHD. Thus, IFN-gamma SFCs may be used to distinguish systemic infections from aGVHD.
Hirayama
Masahiro
M
Department of Pediatrics and Cell Transplantation, Mie University School of Medicine, Tsu, Mie, Japan.
Azuma
Eiichi
E
Kumamoto
Tadashi
T
Iwamoto
Shotaro
S
Nashida
Yuji
Y
Araki
Mariko
M
Yamada
Hiroshi
H
Dida
Francis
F
Tamaki
Shigehisa
S
Kawakami
Keiki
K
Kageyama
Shinichi
S
Nakano
Takashi
T
Yamamoto
Hatsumi
H
Komada
Yoshihiro
Y
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007223:Infant; D007239:Infections / Q000175:diagnosis* / Q000276:immunology; D007371:Interferon-gamma / Q000097:blood*; D008297:Male; D033581:Stem Cell Transplantation / Q000009:adverse effects*
D007371:Interferon-gamma