High levels of B cell activating factor during the peritransplantation period are associated with a reduced incidence of acute graft-versus-host disease following myeloablative allogeneic stem cell transplantation.
B cell activating factor (BAFF), also known as B cell survival and activation factor, is associated with autoimmune disease and chronic graft-versus-host disease (cGVHD). T cells are known to be modulated by soluble BAFF (sBAFF). Considering the possible association of sBAFF with T cell as well as B cell function, sBAFF during the peritransplantation period may affect the development of acute GVHD (aGVHD). To test this hypothesis, we evaluated 45 patients who had undergone myeloablative (MA) allogeneic stem cell transplantation (SCT) for hematologic malignancy. Serum sBAFF levels were measured before conditioning and on day 0, day +7, and day +14. Thirty-three of the 45 patients (cumulative incidence, 73%) developed aGVHD between 16 days and 98 days posttransplantation. Repeated-measures analysis of variance revealed significantly lower sBAFF levels during the peritransplantation period in patients with aGVHD than in those without aGVHD (P=.001). Receiver operating characteristic curve analysis revealed that sBAFF levels at every time point were available for the prediction of aGVHD development, and that patients with a sBAFF level >43 pg/mL at each time point (which could ensure 75% sensitivity and 73%-82% specificity for the prediction of aGVHD at every time point) had a significantly lower cumulative incidence of aGVHD. This study is the first to demonstrate that sBAFF level during the peritransplantation period not only may be predictive of aGVHD, but also may have a protective effect against aGVHD in humans. Further investigation is needed to confirm our findings.
Cho
Byung-Sik
BS
Department of Hematology, Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Min
Chang-Ki
CK
Kim
Hee-Je
HJ
Lee
Seok
S
Kim
Yoo-Jin
YJ
Lim
Ji-Young
JY
Jeong
Dae-Chul
DC
Cho
Bin
B
Kim
Hack-Ki
HK
Eom
Ki-Seong
KS
Cho
Seok-Goo
SG
Kim
Dong-Wook
DW
Lee
Jong-Wook
JW
Min
Woo-Sung
WS
Kim
Chun-Choo
CC
Chung
Nak-Gyun
NG
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D053264:B-Cell Activating Factor / Q000097:blood* / Q000502:physiology; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis*; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists; D011237:Predictive Value of Tests; D020011:Protective Agents; D012372:ROC Curve; D014184:Transplantation, Homologous; D055815:Young Adult
D053264:B-Cell Activating Factor; D019653:Myeloablative Agonists; D020011:Protective Agents