TY - JOUR
T1 - Change in plasma tumor necrosis factor receptor 1 levels in the first week after myeloablative allogeneic transplantation correlates with severity and incidence of GVHD and survival
AU - Choi, Sung W.
AU - Kitko, Carrie L.
AU - Braun, Thomas
AU - Paczesny, Sophie
AU - Yanik, Gregory
AU - Mineishi, Shin
AU - Krijanovski, Oleg
AU - Jones, Dawn
AU - Whitfield, Joel
AU - Cooke, Kenneth
AU - Hutchinson, Raymond J.
AU - Ferrara, James L.M.
AU - Levine, John E.
PY - 2008/8/15
Y1 - 2008/8/15
N2 - Acute graft-versus-host disease (GVHD) remains a significant cause of mortality after hematopoietic cell transplantation (HCT). Tumor necrosis factor-alpha (TNF-α) mediates GVHD by amplifying donor immune responses to host tissues and by direct toxicity to target organs.We measured TNF receptor 1 (TNFR1) as a surrogate marker for TNF-α in 438 recipients of myeloablative HCT before transplantation and at day 7 after transplantation. Increases in TNFR1 levels more than or equal to 2.5 baseline correlated with eventual development of GVHD grade 2 to 4 (58% vs 32%, P <.001) and with treatment-related mortality (39% vs 17%, P <.001). In a multivariate analysis including age, degree of HLA match, donor type, recipient and donor sex, disease, and status at HCT, the increase in TNFR1 level at day 7 remained a significant predictor for outcome. Measurement of TNFR1 levels early after transplantation provides independent information in advance of important clinical outcomes, such as GVHD and death.
AB - Acute graft-versus-host disease (GVHD) remains a significant cause of mortality after hematopoietic cell transplantation (HCT). Tumor necrosis factor-alpha (TNF-α) mediates GVHD by amplifying donor immune responses to host tissues and by direct toxicity to target organs.We measured TNF receptor 1 (TNFR1) as a surrogate marker for TNF-α in 438 recipients of myeloablative HCT before transplantation and at day 7 after transplantation. Increases in TNFR1 levels more than or equal to 2.5 baseline correlated with eventual development of GVHD grade 2 to 4 (58% vs 32%, P <.001) and with treatment-related mortality (39% vs 17%, P <.001). In a multivariate analysis including age, degree of HLA match, donor type, recipient and donor sex, disease, and status at HCT, the increase in TNFR1 level at day 7 remained a significant predictor for outcome. Measurement of TNFR1 levels early after transplantation provides independent information in advance of important clinical outcomes, such as GVHD and death.
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U2 - 10.1182/blood-2008-02-138867
DO - 10.1182/blood-2008-02-138867
M3 - Article
C2 - 18502834
AN - SCOPUS:51649121552
SN - 0006-4971
VL - 112
SP - 1539
EP - 1542
JO - Blood
JF - Blood
IS - 4
ER -