Discrimination of acute graft-versus-host disease from infections by enumeration of peripheral blood interferon-gamma spot-forming cells.

Abstract

Infections may coexist and in certain circumstances aggravate acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation. Early detection of aGVHD is often difficult in patients with concurrent infections. Using an enzyme-linked immunospot assay that reflects ongoing immune status in vivo, we enumerated spot-forming cells (SFCs) for interferon (IFN)-gamma, interleukin (IL)-4, and IL-12 in peripheral blood from 56 patients with hematological disorders. Eleven patients had viral, fungal, or bacterial systemic infections during first 10 weeks posttransplant. Of these, six patients with grade 0-I aGVHD showed normal levels of IFN-gamma SFCs. On the other hand, IFN-gamma SFCs were elevated in five patients with grade II-IV aGVHD. These data indicate that increased IFN-gamma SFCs seemed to be correlated with clinically significant aGVHD, but not with infection itself. IL-4 and IL-12 SFCs increased in some patients with infections, irrespective of the presence of aGVHD. Thus, IFN-gamma SFCs may be used to distinguish systemic infections from aGVHD.

• Authors: Masahiro Hirayama, Eiichi Azuma, Tadashi Kumamoto, Shotaro Iwamoto, Yuji Nashida, Mariko Araki, Hiroshi Yamada, Francis Dida, Shigehisa Tamaki, Keiki Kawakami, Shinichi Kageyama, Takashi Nakano, Hatsumi Yamamoto, Yoshihiro Komada
• Journal: Transplantation (Transplantation) Vol. 81 Issue 4 Pg. 632-5 (Feb 27 2006) ISSN: 0041-1337 [Print] United States
• PMID: 16495815 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Interferon-gamma

Topics

• Acute Disease
• Adolescent
• Adult
• Child
• Child, Preschool
• Diagnosis, Differential
• Female
• Graft vs Host Disease (diagnosis, drug therapy, immunology, prevention & control)
• Humans
• Immunosuppression Therapy (methods)
• Infant
• Infections (diagnosis, immunology)
• Interferon-gamma (blood)
• Male
• Stem Cell Transplantation (adverse effects)