Objective: To ascertain the implication of tumor necrosis factor alpha (TNF alpha) in the pathogenesis of acute graft-versus-host disease (aGVHD).
Methods: Plasma TNF alpha levels were assessed by ELISA in 243 sera samples from 40 patients who had undergone allogeneic bone marrow transplantation (BMT). Plasma TNF alpha levels were measured before BMT and at different time points after BMT. The results were correlated with aGVHD, infection and conditioning regimen.
Results: Plasma TNF alpha levels were significantly higher in patients with grade II and grades III-IV aGVHD (0-4.90) micrograms/L and (0.25-4.21) micrograms/L, respectively than in those with grade 0 or I aGVHD, but there was no clear correlation between plasma TNF alpha levels in patients with grade II and grade III-IV aGVHD. Plasma TNF alpha levels in patients with infection were not statistically different from those in patients without infection. The conditioning regimen did not cause a significant rise in TNF alpha levels.
Conclusion: It is indicated that TNF alpha may be useful for the diagnosis of aGVHD and for differentiation between aGVHD and other BMT related complications such as infection.