title: Cytokine serum levels during post-transplant adverse events in 61 pediatric patients after hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Veno-occlusive disease, Graft-versus-Host disease, invasive or localized bacterial, viral and fungal infections are known as adverse events after hematopoietic stem cell transplantation representing the major cause for morbidity and mortality. Detection and differentiation of these adverse events are based on clinical symptoms and routine measurements of laboratory parameters.
  
  
  METHODS
  To identify the role of cytokines as a possible complication-marker for adverse events, 61 consecutive pediatric patients with a median age of 7.0 years who underwent hematopoietic stem cell transplantation were enrolled in this single-center retrospective study. Interleukin-1 beta (IL-1β), soluble interleukin-2 receptor (sIL-2R), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-α serum (TNF-α) levels were regularly assessed after transplantation and during transplantation related adverse events.
  
  
  RESULTS
  Veno-occlusive disease was accompanied by a significant increase in levels of IL-6, IL-8 and TNF-α.Graft-versus-Host disease was associated with a significant increase of IL-10, sIL-2R, IL-6 and TNF-α, depending on the respective stage or grade. Cytokine IL-6 enabled a significant differentiation between sepsis and fungemia, sepsis and viremia, and sepsis and bacteremia. Moreover, cytokine IL-8 enabled a significant differentiation between sepsis and viremia, sepsis and bacteremia, and bacteremia and viremia whereas IL-10 made a distinction between sepsis and viremia possible.
  
  
  CONCLUSIONS
  The data demonstrate that proinflammatory cytokines might be putative indicators for early detection and differentiation of post-transplant adverse events and may allow prompt and adequate clinical intervention. Prospective clinical trials are needed to evaluate these findings.
authors: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany. michaela.doering@med.uni-tuebingen.de.
authors: Michaela
authors: M
authors: Döring
authors: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany. karin.cabanillas@med.uni-tuebingen.de.
authors: Karin Melanie
authors: KM
authors: Cabanillas Stanchi
authors: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany. markus.mezger@med.uni-tuebingen.de.
authors: Markus
authors: M
authors: Mezger
authors: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany. annika.erbacher@med.uni-tuebingen.de.
authors: Annika
authors: A
authors: Erbacher
authors: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany. judith.feucht@med.uni-tuebingen.de.
authors: Judith
authors: J
authors: Feucht
authors: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany. matthias.pfeiffer@med.uni-tuebingen.de.
authors: Matthias
authors: M
authors: Pfeiffer
authors: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany. peter.lang@med.uni-tuebingen.de.
authors: Peter
authors: P
authors: Lang
authors: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany. rupert.handgretinger@med.uni-tuebingen.de.
authors: Rupert
authors: R
authors: Handgretinger
authors: Department of Paediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Center for Obstetrics and Paediatrics, Martinistraße 52, 20246, Hamburg, Germany. i.mueller@uke.de.
authors: Ingo
authors: I
authors: Müller
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D009181:Mycoses / Q000209:etiology; D011183:Postoperative Complications / Q000097:blood*; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology; D014652:Vascular Diseases / Q000209:etiology; D014777:Virus Diseases / Q000209:etiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines