Tvedt Tor Henrik, Lie Stein Atle, Reikvam Håkon, Rye Kristin Paulsen, Lindås Roald, Gedde-Dahl Tobias, Ahmed Aymen Bushra, Bruserud Øystein
Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
Department of Clinical Dentistry, University of Bergen, 5020 Bergen, Norway.
Int J Mol Sci. 2016 Nov 1;17(11):1823. doi: 10.3390/ijms17111823.
Several pretransplant factors, including CRP (C-reactive protein) levels, reflect the risk of complications after allogeneic stem cell transplantation. IL-6 induces CRP increase, and we therefore investigated the effects of pretransplant IL-6, soluble IL-6 receptors, IL-6 family cytokines and CRP serum levels on outcome for 100 consecutive allotransplant recipients. All patients had related donors, none had active infections and 99 patients were in complete remission before conditioning. The incidence of acute graft versus host disease (aGVHD) requiring treatment was 40%, survival at Day +100 82%, and overall survival 48%. Despite a significant correlation between pretransplant CRP and IL-6 levels, only CRP levels significantly influenced transplant-related mortality (TRM). However, CRP did not influence overall survival (OS). Pretransplant IL-31 influenced late TRM. Finally, there was a significant association between pretransplant IL-6 and early postconditioning weight gain (i.e., fluid retention), and this fluid retention was a risk factor for aGVHD, TRM and OS. To conclude, pretransplant CRP, IL-31 and early posttransplant fluid retention were independent risk factors for TRM and survival after allotransplantation.
包括C反应蛋白（CRP）水平在内的几种移植前因素反映了异基因干细胞移植后并发症的风险。白细胞介素-6（IL-6）可诱导CRP升高，因此我们研究了移植前IL-6、可溶性IL-6受体、IL-6家族细胞因子和CRP血清水平对100例连续同种异体移植受者预后的影响。所有患者均有相关供者，均无活动性感染，99例患者在预处理前处于完全缓解状态。需要治疗的急性移植物抗宿主病（aGVHD）发生率为40%，+100天时生存率为82%，总生存率为48%。尽管移植前CRP与IL-6水平之间存在显著相关性，但只有CRP水平显著影响移植相关死亡率（TRM）。然而，CRP并不影响总生存率（OS）。移植前IL-31影响晚期TRM。最后，移植前IL-6与预处理后早期体重增加（即液体潴留）之间存在显著关联，这种液体潴留是aGVHD、TRM和OS的危险因素。总之，移植前CRP、IL-31和移植后早期液体潴留是同种异体移植后TRM和生存的独立危险因素。
