SOLUBLE INTERLEUKIN-2 RECEPTOR SERUM LEVELS AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION AS A MARKER FOR GVHD

Acute GVHD (aGVHD) is one of the major problems after allogeneic BMT. The diagnosis of aGVHD is difficult to establish, relying mainly on cl inical evaluations and symptoms of aGVHD, often resembling those of or gan toxicity, infection or drug rash, In 21 patients after BMT several serum cytokine levels (soluble interleukin-2 receptor (sIL-2R), sTNF- R, SCF, IL-6, IL-8, G-SCF and ICAM-1) were determined in order to eval uate their value as an indicator for aGVHD, The maximum levels of sIL- 2R (and none of the other evaluated cytokines) correlated significantl y (r = 0.8, P = 0.008) with the severity of aGVHD, We also found a sig nificant correlation between the day of engraftment (neutrophil count > 0.5 x 10(9)/l) and the severity of aGVHD (r = 0.5, P = 0.03): engraf tment was earlier in patients without aGVHD (median of day 11) than in those with aGVHD (median of day 18), No correlation between sIL-2R an d fever or organ toxicity could be found, Our data suggest that the sI L-2R level might be an indicator for aGVHD, reflecting the severity of the disease, In patients with late engraftment the risk of aGVHD seem s to be increased, therefore these patients especially should be monit ored closely, possibly using sIL-2R levels.