Serum TNFα levels in patients with acute graft-versus-host disease after bone marrow transplantation

Tumor necrosis factor alpha (TNF alpha) has been implicated in the pathogenesis of graft-versus-host disease (GVHD). In this study, serum levels of TNF alpha were assessed by ELISA in 243 sera samples from 40 patients who had undergone allogeneic bone marrow transplantation (BMT). Serum TNF alpha levels were measured before BMT and at different time points after BMT. The results were correlated with acute GVHD (aGVHD), infection and conditioning regimen. Serum TNF alpha levels were significantly higher in patients with grades II-IV aGVHD than in those with grade 0 or I aGVHD, but there was no clear correlation between serum TNF alpha and severity of aGVHD. Serum TNF alpha levels in infected patients were not statistically different from those in patients without infection. The conditioning regimen did not cause a significant rise in TNF alpha levels. These results indicate that TNF alpha may be useful for the diagnosis of aGVHD and for differentiating between aGVHD and other BMT-related complications, such as infection.