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同种异体干细胞移植后应用环磷酰胺后促炎细胞因子谱。

Profiles of pro-inflammatory cytokines in allogenic stem cell transplantation with post-transplant cyclophosphamide.

机构信息

R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russian Federation.

R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russian Federation.

出版信息

Cytokine. 2017 Nov;99:148-153. doi: 10.1016/j.cyto.2017.08.016. Epub 2017 Sep 9.

Abstract

Large number of studies was published about predictive value of cytokines for graft-versus-host disease (GVHD) after allogeneic stem cell transplantation. Recently, there has been a growing interest in GVHD prophylaxis with post-transplant cyclophosphamide (PTCy). Clinical data on the dynamics of proinflammatory cytokines with this prophylaxis is lacking. In this study, we have measured the levels of IL-17, IL-6, IL-8, IFN-γ and TNF-α in plasma on days -7, 0, +7, +14 and after engraftment in 20 patients with acute GVHD and 40 matched control patients with PTCy-based prophylaxis. Low levels of IL-8 (p=0.04) on day +7 and IFN-γ (p=0.03) after engraftment were associated with grade II-IV acute GVHD. The same pattern was observed for severe acute GVHD. Low IFN-γ after engraftment was also associated with increased non-relapse mortality (p=0.014). No impact of cytokine levels on overall survival and relapse incidence was observed (p>0.05). In conclusion, the dynamics of IL-8 and IFN-γ in GVHD patients after PTCy was different from previously reported after conventional prophylaxis.

摘要

大量研究发表了关于同种异体干细胞移植后细胞因子对移植物抗宿主病(GVHD)的预测价值。最近,人们对移植后环磷酰胺(PTCy)预防 GVHD 越来越感兴趣。关于这种预防措施的促炎细胞因子动力学的临床数据尚缺乏。在这项研究中,我们测量了 20 例急性 GVHD 患者和 40 例接受 PTCy 预防的匹配对照患者在移植前 7 天、0 天、+7 天、+14 天和移植后的血浆中 IL-17、IL-6、IL-8、IFN-γ 和 TNF-α水平。+7 天的低水平 IL-8(p=0.04)和移植后的 IFN-γ(p=0.03)与 II-IV 级急性 GVHD 相关。严重的急性 GVHD 也观察到了相同的模式。移植后 IFN-γ水平低也与非复发死亡率增加相关(p=0.014)。细胞因子水平对总生存和复发发生率没有影响(p>0.05)。总之,PTCy 后 GVHD 患者中 IL-8 和 IFN-γ 的动态与以前报道的常规预防后的动态不同。

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