title: Clinical significance of B cell-activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.
abstract: BACKGROUND
  BAFF (B cell-activating factor) and APRIL (a proliferation-inducing ligand) are members of the tumor necrosis factor family and promote B cell survival and proliferation. We evaluated the correlation between serum concentration of BAFF or APRIL and severity of acute graft-versus-host disease (GVHD).
  
  
  METHODS
  Fifteen patients who received allogeneic hematopoietic stem transplantation for leukemia and developed acute GVHD were enrolled. We determined serum concentrations of BAFF and APRIL at the onset of the first clinical manifestation of GVHD by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Nine patients had grade 2 acute GVHD, and 6 had grade 3-4 acute GVHD. The BAFF serum concentration was higher in patients with grade 3-4 acute GVHD (1,093.42 in grade 2 vs. 2,171.99 pg/mL in grade 3-4), although the difference was not significant (P=0.077). However, the ratio of BAFF serum concentration to absolute lymphocyte count (ALC) (BAFF/ALC) was significantly higher in patients with grade 3-4 acute GVHD (P=0.045). The APRIL serum concentration and APRIL/ALC ratio showed similar results (P=0.077 and P=0.013, respectively).
  
  
  CONCLUSIONS
  Patients with grade 3-4 acute GVHD had higher BAFF/ALC and APRIL/ALC ratios than patients with grade 2 acute GVHD. These findings suggest that B cells might play an important role in the development of acute GVHD, and that the BAFF and APRIL concentrations in serum might be significant predictive factors for estimating the severity of acute GVHD. Their clinical significance should be further evaluated in a larger patient population.
authors: Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors: Jin Seok
authors: JS
authors: Kim
authors: Soo-Jeong
authors: SJ
authors: Kim
authors: June-Won
authors: JW
authors: Cheong
authors: Yundeok
authors: Y
authors: Kim
authors: Doh Yu
authors: DY
authors: Hwang
authors: Sulhee
authors: S
authors: Yoon
authors: Jieun
authors: J
authors: Jang
authors: Shin Young
authors: SY
authors: Hyun
authors: Yoo Hong
authors: YH
authors: Min