CYTOKINE INVOLVEMENT IN PREDICTING CLINICAL GRAFT-VERSUS-HOST DISEASEIN ALLOGENEIC BONE-MARROW TRANSPLANT RECIPIENTS

An in vitro skin explant model has been used to predict the severity o f acute graft-versus-host disease (GVHD) in 34 HLA-identical bone marr ow transplant recipients (correlation coefficient 0.6 p < 0.001). Supe rnatants from HLA-matched patient/donor mixed lymphocyte cultures (MLC s) were analysed for levels oftumour necrosis factor alpha (TNF alpha) and interferon gamma (IFN gamma). High levels of both cytokines corre lated with the developmentof GVHD grades II or above (p < 0.05). The s upernatants were also tested for induction of class II MHC antigen exp ression on third party skin and results correlated with clinical outco me in 17 of 22 cases (77%) (correlation coefficient 0.65, p < 0.001. T he results suggest that measurement of both TNF alpha and IFN gamma in HLA-matched MLC supernatants is of predictive value and that the skin explant model is a useful model for studying the aetiology of GVHD in humans.