RELATION BETWEEN TUMOR-NECROSIS-FACTOR-ALPHA AND GRAFT-VERSUS-HOST DISEASE IN ALLOGENEIC BONE-MARROW TRANSPLANTATION

Tumour necrosis factor alpha (TNF-alpha) was measured in the sera of 1 9 patients pre- and weekly post-allogeneic bone marrow transplantation (BMT). All marrow donors were HLA identical siblings. The level was e levated in seven cases and five of them developed severe acute graft v ersus host disease (aGVHD) grade 3 and 4. This relation was statistica lly significant (p = 0.008). 12 patients had undetectable TNF-alpha pr e- and post BMT, four patients developed grade 1 and 2 and one patient grade 4 aGVHD. The probability of developing aGVHD versus no GVHD amo ng patients with undetectable TNF-alpha was not statistically signific ant (p = 0.72). TNF-alpha levels were elevated pre transplant in four out of six patients who developed severe aGVHD. This fact may point to TNF-alpha as a strong predictor of severe aGVHD in allogeneic BMT.