Published online Sep 27, 2022. doi: 10.4331/wjbc.v13.i4.72
Peer-review started: March 8, 2022
First decision: April 25, 2022
Revised: May 11, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: September 27, 2022
Processing time: 201 Days and 8.5 Hours
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may be related to the occurrence of complications, including graft-versus-host disease (GvHD) and infections. The pathogenesis of acute GvHD is connected with T lymphocytes, which identify alloantigens on host's antigen-presenting cells, activate production of interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), and act on the immune effector cells and damage tissues and organs.
The aim of the study was to investigate and distinguish serum concentration profiles of IFN-gamma and IL-2 within a 30-d period after allo-HSCT.
We enrolled 62 patients, i.e., 30 (48%) male and 32 (52%) female subjects [median age 49.5 (19-68) years], after allo-HSCT from siblings (n = 12) or unrelated donors (n = 50) due to acute myeloid leukemia with myeloablative conditioning (n = 26; 42%) and with non-myeloablative conditioning (n = 36; 58%). All patients were given standard immunosuppressive therapy with cyclosporin-A and methotrexate and pre-transplant antithymocyte globulin in the unrelated setting. Blood samples were collected pre-transplant before and after (on day -1) the conditioning therapy and on days +2,+4, +6, +10, +20, and +30 after allo-HSCT. Serum levels of IL-2 and IFN-gamma were determined using ELISA.
Patients were divided into four groups depending on the presence of acute GvHD and clinical manifestations of infection. Group I included patients with neither acute GvHD nor infections [n = 15 (24%)], group II consisted of patients with infections without acute GvHD [n = 17 (27%)], group III was comprised of patients with acute GvHD without infections [n = 9 (15%)], and group IV included patients with both acute GvHD and infections [n = 21 (34%)]. IFN-gamma concentrations were higher in Group II than in other groups on days +20 (P = 0.014) and +30 (P = 0.008). Post-hoc tests showed lower concentrations of IFN-gamma on day +30 in groups I (P = 0.039) and IV (P = 0.017) compared to group II. The levels of IL-2 were mostly undetectable.
Serum levels of IFN-gamma following allo-HSCT progressively escalate. High serum levels of IFN-gamma are related to infectious complications rather than acute GvHD. Serum concentrations of IL-2 in most patients are undetectable.
Core Tip: This paper presents the profiles of interleukin-2 and interferon-gamma levels depending on the occurrence of acute graft-versus-host disease and infection complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this study, the cytokine levels were assessed in the early period after allo-HSCT (within the first 30 d after transplantation). Before, during, and after blood sampling for cytokine determination, cytokine-producing cells were not stimulated with mitogenic substances (lipopolysaccharide or phytohemagglutinin). Therefore, the obtained cytokine levels and their profiles may be regarded as those which reflect real values in patients who underwent allo-HSCT.