The predictive value of stimulation index calculated by modified mixed lymphocyte culture in the detection of GVHD following hematopoietic stem cell transplantation.
OBJECTIVE
Mixed lymphocyte culture (MLC) is one of the routine tests performed prior to hematopoietic stem cell transplantation (HSCT) as a predictive assay for assessing the quality of donor matching and graft-versus-host disease (GVHD). The stimulation index is one of the formulas of the MLC test, and it is used for evaluation of matching between donor and recipient. Modified MLC (mMLC) test is produced by adding various cytokines to the MLC test, and increased sensitivity has been reported with this modification.


METHODS
The importance of the stimulation index values in MLC and mMLC tests was evaluated in 59 patients who received HSCs from human leukocyte antigen-identical sibling donors. In the mMLC test, cytokines were added as interleukin (IL)-2, IL-2 + IL-4 and IL-2 + interferon (IFN)-gamma + tumor necrosis factor (TNF)-alpha. Stimulation index values in mMLC test were compared with stimulation index values in MLC test.


RESULTS
Twenty-three (39%) patients developed GVHD. When evaluated in terms of stimulation index >1 patients, in MLC, 55% of the patients developed GVHD (p=0.229), whereas these values were 75% in the IL-2 added mMLC test (p=0.035), 100% in the IL-2 + IL-4 added mMLC test (p=0.076) and 85.7% in the IL-2 + IFN-gamma + TNF-alpha added mMLC test (p=0.015).


CONCLUSIONS
mMLC increased the sensitivity of the test. The relation between the positive results and evidence of GVHD after transplantation was found significant.
Şemsettin Günaltay Caddesi. Sultan Sokak. Çağdaş Apartmanı. No: 9/22 Erenköy İstanbul, Türkiye Phone: +90 532 296 66 86 E-mail: hulyasn@gmail.com.
Hülya
H
Sayılan Şen
Tülay
T
Kılıçaslan Ayna
Hayriye
H
Şentürk Çiftçi
Sevgi
S
Kalayoğlu Beşışık
Emel Ayşe
EA
Onal
Arzu
A
Akçay
Hülya
H
Bilgen
Mehmet
M
Gürtekin
Deniz
D
Sargın
Mahmut
M
Çarin