Elevated IL-1Ra Levels in the Stem Cell Product Is Associated with the Development of Engraftment Syndrome Following Autologous Stem Cell Transplantation for the Treatment of Multiple Myeloma and Lymphoma

Engraftment syndrome (ES) is a frequently occurring complication in patients receiving autologous stem cell transplantation (ASCT) for the treatment of multiple myeloma and various types of non-Hodgkin lymphomas. This clinical entity presents as skin rashes, diarrhea, non-infectious fevers and capillary leak syndrome in the peri-engraftment period coinciding with neutrophil recovery. The etiology and risk factors contributing to the development of ES remain unclear. The goal of the present study was to analyze the cytokine composition of the grafted mobilized peripheral blood stem cell product as well as serum cytokine levels in patients undergoing ASCT for the treatment of multiple myeloma and lymphoma. Cytokines were analyzed in the apheresis stem cell product, as well as patient plasma 1-2 days pre-transplant, 12 days post-transplant, and 2-4 months post-transplant using the Luminex xMAP multiplex cytokine platform. The concentrations of 29 cytokines from 38 patients were analyzed. Seventeen of these patients were diagnosed with engraftment syndrome using the Spitzer criteria. Patients who developed ES were shown to have significantly elevated levels of IL-1 receptor antagonist (IL-1Ra) in the apheresis product as compared to patients that did not develop ES (31,033 vs. 6015 pg/ml; p=0.028). IL-1Ra levels were not significantly different at other time points. IL-1Ra competes with IL-1α and IL-1β for binding to the IL-1 receptor thus acting as an antagonist to th...
Source: Blood - Category: Hematology Authors: Tags: 723. Clinical Allogeneic and Autologous Transplantation: Late Complications and Approaches to Disease Recurrence: Poster I Source Type: research