title: Cytokine and chemokine patterns across 100 days after hematopoietic stem cell transplantation in children.
abstract: We mapped the cytokine response to hematopoietic stem cell transplantation (HSCT) by assaying 51 cytokines and chemokines each week for 100 days in 51 children receiving allogeneic (n = 44) or autologous HSCT (n = 7). Assay values were reported as mean fluorescence intensity (MFI). Log transformation converted MFI to clinically relevant measures (ie, pg/mL). We searched for potential markers of transplant complications by using mixed treatment by subject analysis of variance. Global cytokine secretion in HSCT recipients was significantly lower than in concurrent control patients (n = 11). Coincident with the nadir in WBC count, the concentration of many cytokines declined further by the second and third week. All analytes (except monokine induced by gamma interferon [MIG]) subsequently rebounded by week 4 (coincident with engraftment and recovery of WBC count) but often still remained well below control levels. Concurrent with the collective nadir of multiple cytokines, monocyte chemoattractant protein 1 (MCP-1), growth-regulated oncogene alpha (GRO-a), and leptin surged during weeks 2 to 4. High levels of leptin persisted throughout the 100 post-transplant days. Also during weeks 2 to 4, hepatocyte growth factor (HGF) and IL-6 surged in children with complications but not in those without complications. The peak in HGF was more pronounced in veno-occlusive disease (VOD). HGF and IL-6 secretion rose at least 2 weeks before the clinical diagnosis of VOD or graft-versus-host disease (GVHD). From week 4 onward in all groups, the MFI of the cytokine resistin increased to 5 to 15 times above concurrent control. HGF has now emerged in 3 or more biomarker discovery efforts for GVHD (and in our population for VOD as well). HGF (with or without IL-6) should be investigated as a potential predictive biomarker of VOD or GVHD. Alternatively, the hyperinflammatory "signature" provided by a multicytokine assay may be predictive.
authors: Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California. Electronic address: jdicarlo@chla.usc.edu.
authors: Joseph
authors: J
authors: DiCarlo
authors: Department of Pediatric Stem Cell Transplantation, Stanford University School of Medicine, Stanford, California.
authors: Rajni
authors: R
authors: Agarwal-Hashmi
authors: Department of Hematology/Oncology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
authors: Ami
authors: A
authors: Shah
authors: Pediatric Critical Care, NYU Langone Medical Center, New York, New York.
authors: Paul
authors: P
authors: Kim
authors: Department of Pediatric Stem Cell Transplantation, Stanford University School of Medicine, Stanford, California.
authors: Laila
authors: L
authors: Craveiro
authors: Department of Bone Marrow Transplant, Children's Hospital Los Angeles, Los Angeles, California.
authors: Renna
authors: R
authors: Killen
authors: Human Immune Monitoring Center, Stanford University School of Medicine, Stanford, California.
authors: Yael
authors: Y
authors: Rosenberg-Hasson
authors: Human Immune Monitoring Center, Stanford University School of Medicine, Stanford, California.
authors: Holden
authors: H
authors: Maecker
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000473:pathology; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006504:Hepatic Veno-Occlusive Disease / Q000276:immunology / Q000473:pathology; D017228:Hepatocyte Growth Factor / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000098:blood supply / Q000276:immunology / Q000473:pathology; D008297:Male; D011446:Prospective Studies; D052243:Resistin / Q000276:immunology* / Q000378:metabolism; D016019:Survival Analysis; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D000970:Antineoplastic Agents; D016207:Cytokines; C066855:HGF protein, human; C499624:RETN protein, human; D052243:Resistin; D017228:Hepatocyte Growth Factor
keywords: Bone marrow transplantation; Cytokines; Graft-versus-host disease; Hepatocyte growth factor; Veno-occlusive disease