title: Soluble interleukin-2 receptor index predicts the development of acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation from unrelated donors.
abstract: Acute graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is associated with significant morbidity and mortality. In the present study, we retrospectively evaluated whether soluble interleukin-2 receptor (sIL-2R) index, defined as the ratio of serum sIL-2R levels at neutrophil engraftment to those at the pre-conditioning regimen, was predictive of acute GVHD among 51 patients who underwent allogeneic HSCT as their first transplantation and achieved engraftment. The median sIL-2R index was 3.6, and the sIL-2R values were positively associated with acute GVHD severity (grade 0-I: 3.8 ± 2.0 vs. grade II-IV: 7.1 ± 5.7; P = 0.05). Grade II-IV acute GVHD had a cumulative incidence of 31.4 %, and was significantly more frequent among patients with an sIL-2R index of ≥4.5 (≥4.5: 50.0 % vs. <4.5: 21.2 %; P = 0.03). Multivariate analysis revealed that an sIL-2R index of ≥4.5 [hazard ratio (HR) 3.5, P < 0.01] and donor age of >35 years (HR 3.8, P = 0.02) were significant risk factors for grade II-IV acute GVHD. Therefore, increased sIL-2R levels from baseline to engraftment might predict the risk of moderate-to-severe acute GVHD after allogeneic HSCT from an unrelated donor.
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan. nakay@yamaguchi-u.ac.jp.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sugiyama
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tokunaga
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yujiri
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tanizawa
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D006086:Graft vs Host Disease / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012189:Retrospective Studies; D016019:Survival Analysis; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D015375:Receptors, Interleukin-2
keywords: Allogeneic hematopoietic stem cell transplantation; Biomarker; Graft-versus-host disease; Soluble interleukin-2 receptor