title: Vigorous inflammatory responses in noninfectious pulmonary complication induced by donor lymphocyte infusion.
abstract: BACKGROUND
  Donor lymphocyte infusion (DLI) is used for treatment of hematologic malignancy relapse or mixed chimerism after allogeneic hematopoietic stem cell transplantation. Although graft-versus-host disease is well recognized as one of the adverse effects of DLI, there are limited reports on noninfectious pulmonary complications (NIPCs) after DLI.
  
  
  METHODS
  A 55-year-old woman with acute myeloid leukemia received DLI for conversion from recipient predominant to complete donor chimerism on Day +193 after allogeneic HSCT. Eight weeks later, she complained of dyspnea with fever; chest computed tomography revealed diffuse, bilateral, ground glass opacity and reticular appearance. She was diagnosed as having NIPC based on serum and bronchoalveolar lavage fluid (BALF) findings. She was successfully treated with prednisolone (PSL) and completely recovered.
  
  
  CONCLUSIONS
  We analyzed the cell profile from the BALF and 27 cytokines and chemokines in the serum using the Bio-Plex platform. The cells consisted of recipient predominant macrophages and T cells. The serum cytokine and chemokine profile showed significant elevation of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α, macrophage inflammatory protein (MIP)-1α, and MIP-1β, which declined with the improvement of symptoms after initiation of PSL treatment.
  
  
  CONCLUSIONS
  Inflammatory effectors by recipient cells, rather than allogeneic responses by donor cells, played an important role in the pathogenesis of NIPCs after DLI in the present case.
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Nishie
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Fujii
authors.affiliation: Department of Clinical Research, NHO Yamaguchi-Ube Medical Center, Ube, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Mimura
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Takeru
authors.initials: T
authors.lastname: Asano
authors.affiliation: Department of Clinical Research, NHO Yamaguchi-Ube Medical Center, Ube, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Mimura-Kimura
authors.affiliation: Department of Clinical Research, NHO Yamaguchi-Ube Medical Center, Ube, Japan.|Department of Medical Oncology, NHO Yamaguchi-Ube Medical Center, Ube, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Aoe
authors.affiliation: Department of Laboratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Michinori
authors.initials: M
authors.lastname: Aoe
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Nakashima
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Nishimori
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Matsuoka
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Eisei
authors.initials: E
authors.lastname: Kondo
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maeda
authors.affiliation: Department of Hematology and Oncology, Okayama University Hospital, Okayama.
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D016207:Cytokines / Q000378:metabolism*; D004417:Dyspnea / Q000209:etiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D017710:Lymphocyte Transfusion / Q000009:adverse effects*; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D016207:Cytokines