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K Atkinson, GS Incefy, R Storb, KM Sullivan, T Iwata, M Dardenne, HD Ochs, RA Good and ED Thomas
We tested the hypothesis that chronic graft-versus-host disease (GVHD) is
due to inadequate thymic function by examining pretransplant serum levels
of facteur thymique serique (FTS). Four of five patients with no detectable
FTS activity developed chronic GVHD, while one of four with some FTS
activity did. Further patient numbers are needed to confirm or reject this
hypothesis. We further postulated that chronic GVHD, whatever its cause,
involves thymic epithelium as a target organ. When tested 11 mo or more
posttransplant, patients with chronic GVHD had lower absolute FTS levels (p
less than 0.02) and lower age-corrected levels (p = 0.05) than patients
without chronic GHVD. Low values in chronic GVHD were associated with the
disease itself and not its therapy. These findings show that thymic
epithelial secretory function is impaired in chronic GVHD, and this may in
part be responsible for the immunodeficiency characteristic of these
patients.
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