Clinical significance of TNF-alpha, IL-1beta and IFN-gamma levels at early phase after allogeneic hematopoietic stem cell transplantation / 中国实验血液学杂志

ABSTRACT

The objective of this study was to investigate the alterations of cytokines TNF-alpha, IL-1beta and IFN-gamma at early phase after allogeneic hematopoietic stem cell transplantation and in the course of preconditioning, and to explore the relation of these cytokines with transplant-related complications. Alterations of TNF-alpha, IL-1beta, and IFN-gamma levels in serum were detected by ELISA in 95 patients received allogeneic hematopoietic stem cell transplantation (among them 43 cases with GVHD, 5 cases with thrombosis, 31 cases with infection) and 20 in healthy adults. Alterations of the three cytokines were analyzed during the preconditioning and the early phase after transplantation. The results showed that the TNF-alpha levels in aGVHD patients underwent allo-HSCT were already higher than that in normal controls before preconditioning (p<0.01), other patients did not show significant change during this course. TNF-alpha level in all patients were higher than that at day 4 of preconditioning, then decreased at end of preconditioning (p<0.05). TNF-alpha level increased at occurrence of aGVHD, thrombosis and infection, which is most significant in patients with aGVHD, and less significant in patients with infection as compared with patients with thrombosis (p<0.05). TNF-alpha level began to increase at 2 weeks before aGVHD and thrombosis developed in patients, while TNF-alpha levels did not change in patients with infection at the same time. IL-1beta levels did not change during preconditioning, but increased at time of aGVHD, thrombosis and infection in patients, in which IL-1beta levels in patients with thrombosis increased obviously, and more obviously in patients with aGVHD than that in patients with infection (p<0.01). IL-1beta levels in patients with aGVHD began to increase at 1 week before aGHVD developed, but IL-1beta levels in patients with thrombosis began to increase at two weeks before complication developed. IFN-gamma levels did not change in all patients during the process of transplantation. It is concluded that the alterations of cytokine levels exist during the course of allo-HSCT, which reflects the vascular damage following preconditioning and occurrence of some transplant associated complications. Levels of TNF-alpha and IL-1beta are closely related to aGVHD or thrombotic complications. Monitoring changes of TNF-alpha and IL-1beta levels contributes to early discovery of aGVHD and thrombotic complications.