SERUM CATALASE AS MARKER OF GRAFT-VS-HOST DISEASE IN ALLOGENEIC BONE-MARROW TRANSPLANT RECIPIENTS - PILOT-STUDY

We evaluated the efficacies of serum catalase (CAT), 5'-nucleotidase ( 5'NT), and tumor necrosis factor-alpha (TNF) as diagnostic markers of acute graft-vs-host disease (GVHD) in 28 allogeneic bone marrow transp lant recipients by comparing their abilities to discriminate between G VHD-related and non-GVHD-related complications, Mean peak serum CAT co ncentrations for patients with GVHD-related complications (n = 17) wer e about fivefold higher than concentrations in patients with non-GVHD- related complications (n = 25; P = 0.003), whereas the mean peak conce ntrations of serum 5'NT and TNF were not substantially different. Simi larly, the sensitivity and specificity of serum CAT (100% and 88%, res pectively) for use as a diagnostic marker of GVHD were much better tha n those of serum 5'NT (88% and 24%, respectively) or serum TNF (65% an d 4%, respectively). Receiver-operating characteristic plots of all po ssible sensitivity-specificity pairs obtained over the whole range of results also showed that serum CAT has the best diagnostic accuracy. L ow specificities of serum TNF and 5'NT were caused mainly by their inc rease in septicemia, fungal infection, and venoocclusive disease and a fter the use of granulocyte-macrophage colony-stimulating factor to st imulate donor cell engraftment, Serum CAT may prove to be a rapid and relatively noninvasive test for the diagnosis of acute GVHD.