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Proinflammatory cytokines and their role in the development of major transplant-related complications in the early phase after allogeneic bone marrow transplantation

Leukemia volume 17, pages 1150–1156 (2003)Cite this article

Abstract

Serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor (TNF)-alpha were frequently measured during the first 30 days after allogeneic bone marrow transplantation (BMT) in 84 consecutive adult patients. Major transplant-related complications (MTCs) occurred in 33% of cases and included veno-occlusive liver disease, idiopathic pneumonia syndrome, severe endothelial leakage syndrome and >grade II acute graft-versus-host disease. Compared with patients having minor complications, those with MTCs developed higher levels at times of maximal clinical signs (all cytokines, P<0.001), between days 0–5 post-BMT (IL-6 and IL-8, P<0.05) and days 6–10 (L-6, P<0.001; IL-8 and TNF, P<0.01) post-BMT. We could not discriminate patterns of cytokine release that were specific for any subtype of MTC. Higher levels of IL-8 during days 0–5 were associated (P=0.044) with early (<40 days) death. Multivariate analysis including patient and transplant characteristics as well as post-BMT levels of C-reactive protein showed that high average levels of one or more of the cytokines within the first 10 days post-BMT were independently associated with MTC (Odd's ratio: 2.3 [1.2–4.5], P=0.011). This study shows that systemic release of proinflammatory cytokines contributes to the development of MTC and provides a rationale for pre-emptive anti-inflammatory treatment in selected patients.

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Authors and Affiliations

  1. BMT-Unit, Academisch Ziekenhuis-Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussel, Belgium

    R Schots, I Van Riet, T Ben Othman & B Van Camp

  2. Department of Medical Statistics, Academisch Ziekenhuis-Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussel, Belgium

    L Kaufman

  3. Hematology-Immunology-HLA, Academisch Ziekenhuis-Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussel, Belgium

    M De Waele & C Demanet

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Schots, R., Kaufman, L., Van Riet, I. et al. Proinflammatory cytokines and their role in the development of major transplant-related complications in the early phase after allogeneic bone marrow transplantation. Leukemia 17, 1150–1156 (2003). https://doi.org/10.1038/sj.leu.2402946

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