ELEVATED SERUM HLA CLASS-I LEVELS COINCIDE WITH ACUTE AND CHRONIC GRAFT-VERSUS-HOST DISEASE

The ability to predict the likely occurrence of graft-versus-host-dise ase (GVHD) after BMT would be extremely valuable. We performed a retro spective study on the correlation between soluble HLA class I(sHLA-I) levels and GVHD in the sera of 34 patients receiving an allogeneic BMT and in the sera of 12 patients receiving an autologous BMT, sHLA-I le vels measured pre- and at different times post-BMT were correlated wit h the occurrence of post-BMT complications, ie acute graft-versus-host disease (aGVHD), chronic graft-versus-host disease (cGVHD), infection s and relapse, No changes in sHLA-I levels (Delta sHLA-I) occurred in autologous and allogeneic BMT patients without GVHD, In contrast, sHLA -I reached high levels in patients suffering from GVHD, Increased sHLA -I levels correlated strongly with episodes of both acute and chronic GVHD (P = 0.004 and P = 0.005, respectively). Also during relapse incr eased sHLA-I levels were found (P = 0.032), During infections sHLA-I l evels increased, although not significantly, Kinetic studies gave no e vidence that the increase in sHLA-I levels preceded the clinical occur rence of aGVHD or of cGVHD, A slight, but significant correlation was found between total blood bilirubin levels and sHLA-I levels in patien ts suffering from GVHD (P = 0.037), indicating the contribution of the liver as a source of sHLA-I, We conclude that measurements of sHLA-I levels do not function as a predictive parameter for GVHD, but can be valuable for the monitoring of GVHD after BMT.