Pretransplant Levels of CRP and Interleukin-6 Family Cytokines; Effects on Outcome after Allogeneic Stem Cell Transplantation

Int J Mol Sci. 2016 Nov 1;17(11):1823. doi: 10.3390/ijms17111823.

Abstract

Several pretransplant factors, including CRP (C-reactive protein) levels, reflect the risk of complications after allogeneic stem cell transplantation. IL-6 induces CRP increase, and we therefore investigated the effects of pretransplant IL-6, soluble IL-6 receptors, IL-6 family cytokines and CRP serum levels on outcome for 100 consecutive allotransplant recipients. All patients had related donors, none had active infections and 99 patients were in complete remission before conditioning. The incidence of acute graft versus host disease (aGVHD) requiring treatment was 40%, survival at Day +100 82%, and overall survival 48%. Despite a significant correlation between pretransplant CRP and IL-6 levels, only CRP levels significantly influenced transplant-related mortality (TRM). However, CRP did not influence overall survival (OS). Pretransplant IL-31 influenced late TRM. Finally, there was a significant association between pretransplant IL-6 and early postconditioning weight gain (i.e., fluid retention), and this fluid retention was a risk factor for aGVHD, TRM and OS. To conclude, pretransplant CRP, IL-31 and early posttransplant fluid retention were independent risk factors for TRM and survival after allotransplantation.

Keywords: C reactive protein; allogeneic stem cell transplantation; comorbidity; fluid retention; graft versus host disease; interleukin 31; interleukin 6.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • C-Reactive Protein / metabolism*
  • Cytokine Receptor gp130 / blood*
  • Female
  • Graft vs Host Disease / blood
  • Graft vs Host Disease / diagnosis
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Interleukin-6 / blood*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Proportional Hazards Models
  • Receptors, Interleukin-6 / blood*
  • Remission Induction
  • Time Factors
  • Transplantation, Homologous
  • Weight Gain
  • Young Adult

Substances

  • Interleukin-6
  • Receptors, Interleukin-6
  • Cytokine Receptor gp130
  • C-Reactive Protein