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Blood, 15 December 2005, Vol. 106, No. 13, pp. 4407-4411. Prepublished online as a Blood First Edition Paper on September 1, 2005; DOI 10.1182/blood-2005-07-2919.
TRANSPLANTATION Inflammatory cytokines and acute graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantationFrom the Département d'Oncologie Médicale, the Laboratoire d'Immunologie des Tumeurs, the Unité de Transplantation et de Thérapie Cellulaire (UTTC); and the Département d'Hématologie, Institut Paoli-Calmettes, Marseille; Institut National de la Santé et de la Recherche Médicale (INSERM) Unite Mixté de Recherche (UMR) 599, Marseille; and the Université de la Méditerranée, Marseille, France.
This study investigated the role of inflammatory cytokines in acute graft-versus-host disease (aGVHD) incidence and severity in 113 patients who underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT). Among all tested cytokines in the first 3 months after allo-SCT, only interleukin-12 p70 (IL-12p70) levels in the first month were significantly associated with grades II to IV aGVHD development (P < .001). IL-12p70 levels were directly correlated with aGVHD severity grade (P < .001). Before aGVHD onset, blood monocytes, the main precursor pool of IL12p70-secreting dendritic cells, recovered more rapidly in patients with grades II to IV aGVHD (P = .005). Similarly, at the effector level, there was a more robust reconstitution of naive CD3+CD4+CD45RA+CD27+ T cells in patients developing grades II to IV aGVHD (P = .006). In multivariate analysis, IL-12p70 level measured in the first month was the strongest predictive factor for aGVHD development (P < .001). These findings, reconstituting a TH1 loop, support a model in which aGVHD reflects a type 1 alloreaction after RIC allo-SCT.
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