Yazarlar : Melenhorst JJ, Tian X, Xu D, Sandler NG, Scheinberg P, Biancotto A, Scheinberg P, McCoy JP, Hensel NF, McIver Z, Douek DC, Barrett AJ.

Yayın : Haematologica.

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22133778

Konu : Kemik İliği Nakli

Literatür İçeriği :  

Abstract

Background Allogeneic hematopoietic stem cell transplantation is associated with profound changes in levels of various cytokines. Emphasis has been placed on conditioning-associated mucosal damage and neutropenia and associated bacterial translocation as the initiating conditions predisposing to acute graft-versus-host disease. The post-transplant period is, however, also associated with increases in certain homeostatic cytokines. It is unclear how much the homeostatic drive to lymphocyte recovery and the production of cytokines from the engrafting donor immune system determine cytokine fluctuations in the peri- and immediate post-transplant period. The aim of this study was to examine the contribution of the conditioning regimen, donor engraftment, infections, and graft-versus-host disease to fluctuations in cytokines involved in a.o. homeostasis and inflammation.Design and MethodsWe examined the levels of 33 cytokines in relation to peri- and post-transplant events such as conditioning regimen, chimerism, and acute graft-versus-host disease in myeloablative, non-T cell replete HLA-identical sibling donor stem cell transplantation for hematological malignancy. ResultsWe identified two cytokine storms: The first occurred following conditioning and reached peak levels when all the leukocytes were lowest; the second cytokine storm occurred concurrent with hematopoietic reconstitution and subsided with the achievement of full donor lymphocyte chimerism. ConclusionsThus, both patient and donor contribute to the changes in cytokine levels.The study reported here was performed using plasma samples drawn from patients enrolled in the ClinicalTrials.gov-registered trials NCT00467961 and NCT00378534.

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