title: Low levels of interleukin-1 receptor antagonist (IL-1RA) predict engraftment syndrome after autologous stem cell transplantation in POEMS syndrome and other plasma cell neoplasms.
abstract: A rare, multisystem, plasma cell neoplasm, POEMS (polyradiculoneuropathy, organomegaly, endocrinopathy, M-spike, skin changes) syndrome is characterized by an abundance of proinflammatory and angiogenic cytokines. Patients with POEMS are known to have a high incidence of engraftment syndrome after autologous stem cell transplantation. We conducted a pilot study assessing levels of 30 different pro- and anti-inflammatory cytokines before and serially after transplantation in 18 patients with plasma cell neoplasms: POEMS syndrome (n = 9), multiple myeloma (n = 4), and amyloidosis (n = 5). We show that POEMS patients have higher pretransplantation levels of IL-4, IL-10, IL-13, IFN-α, and EGF as compared with those with non-POEMS plasma cell neoplasms. Higher pre- and posttransplantation IL-13 levels correlated with delayed neutrophil engraftment in POEMS patients. Low posttransplantation IL-1RA levels correlated with engraftment syndrome in both POEMS and non-POEMS patients. We conclude that differences in the peri-transplantation cytokine milieu may explain the higher transplantation morbidity in patients with POEMS syndrome. Our results need validation in a larger cohort.
authors.affiliation: North Shore Long Island Jewish Hospital, New York, USA.
authors.forename: Alla
authors.initials: A
authors.lastname: Keyzner
authors.forename: Anita
authors.initials: A
authors.lastname: D'Souza
authors.forename: Martha
authors.initials: M
authors.lastname: Lacy
authors.forename: Morie
authors.initials: M
authors.lastname: Gertz
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hayman
authors.forename: Francis
authors.initials: F
authors.lastname: Buadi
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.forename: David
authors.initials: D
authors.lastname: Dingli
authors.forename: Ann
authors.initials: A
authors.lastname: Engebretson
authors.forename: Caili
authors.initials: C
authors.lastname: Tong
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
mesh_terms: D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood / Q000276:immunology; D005260:Female; D006085:Graft Survival / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D054219:Neoplasms, Plasma Cell / Q000097:blood* / Q000276:immunology / Q000601:surgery*; D016878:POEMS Syndrome / Q000097:blood* / Q000276:immunology / Q000601:surgery; D010865:Pilot Projects; D011237:Predictive Value of Tests; D017472:Receptors, Interleukin-1 / Q000097:blood / Q000276:immunology; D014182:Transplantation, Autologous
chemical_list: D016207:Cytokines; D053590:Interleukin 1 Receptor Antagonist Protein; D017472:Receptors, Interleukin-1
keywords: Cytokines; IL-13; IL-1RA; Neutrophil engraftment