CHANGE OF SERUM ALPHA-1 MICROGLOBULIN AND BETA-2-MICROGLOBULIN FOLLOWING ALLOGENEIC BONE-MARROW TRANSPLANTATION

By serially measuring serum levels of alpha-1 microglobulin and beta-2 microglobulin following allogeneic bone marrow transplantation (BMT), we tried to define their relationship to renal dysfunction, acute gra ft-versus-host disease (GVHD) and infection as complications of the tr ansplantation. The study involved a total of 25 patients with leukemia , myelodysplastic syndrome and aplastic anemia who received BMT in thi s department; one patient received re-transplantation, thus bringing t he total number of transplants to 26. Twenty-four patients received BM T from HLA-identical siblings while two others received BMT from unrel ated donors. Alpha-1 microglobulin was within normal limits in all pat ients before BMT; among various complications such as nephrotoxicity, acute GVHD and infection which took place after transplantation, a rai sed alpha-1 microglobulin level was found only in nephrotoxicity; howe ver, the increase was not significant compared with the pre-transplant ation level. The pre-transplantation beta-2 microglobulin level was hi gher than normal in some patients; it was significantly increased in a ll of the above complications compared with the pretransplantation lev el (1.57 +/- 0.571 mg/l), A significant correlation was found between the serum creatinine level and the beta-2 microglobulin level (r = 0.8 49) in patients with renal dysfunction. In some patients, however, the beta-2 microglobulin level increased earlier than the serum creatinin e level, and this finding was considered useful for the early diagnosi s of renal dysfunction following allogeneic BMT.