Vigorous inflammatory responses in noninfectious pulmonary complication induced by donor lymphocyte infusion.
Vigorous inflammatory responses in noninfectious pulmonary complication induced by donor lymphocyte infusion.
复制标题
供体淋巴细胞输注引起的非感染性肺部并发症中的剧烈炎症反应。
DOI：
10.1111/trf.13283
复制
发表时间：
2016
期刊：
影响因子：
2.9
通讯作者：
Tanimoto M.
中科院分区：
文献类型：
--
作者：
Nishie M;Fujii N;Mimura Y;Asano T;Mimura-Kimura Y;Aoe K;Aoe M;Nakashima H;Fujiwara H;Nishimori H;Matsuoka K;Kondo E;Maeda Y;Tanimoto M.
背景供者淋巴细胞输注(DLI)用于异基因造血干细胞移植后恶性血液病复发或混合嵌合体的治疗。尽管移植物抗宿主病被公认为DLI的不良反应之一，但有关DLI后非感染性肺部并发症(NIPC)的报道有限。8周后，她主诉呼吸困难并发烧；胸部计算机断层扫描显示弥漫性、双侧、磨玻璃样混浊和网状外观。根据血清和支气管肺泡灌洗液(BALF)检查结果，她被诊断为NIPC。我们利用Bio-Plex平台分析了BALF中的细胞图谱和血清中的27种细胞因子和趋化因子。细胞由受体占优势的巨噬细胞和T细胞组成。IL-−-1β、IL-6、IL-8、肿瘤坏死因子-α、巨噬细胞炎性蛋白−-1α、IL-1β在治疗后明显升高，治疗后随着症状的改善而下降。结论受者细胞的炎症效应而非供体细胞的同种异体反应在本病例DLI后NIPC的发病机制中起重要作用。
BACKGROUNDDonor lymphocyte infusion (DLI) is used for treatment of hematologic malignancy relapse or mixed chimerism after allogeneic hematopoietic stem cell transplantation. Although graft‐versus‐host disease is well recognized as one of the adverse effects of DLI, there are limited reports on noninfectious pulmonary complications (NIPCs) after DLI.CASE REPORTA 55‐year‐old woman with acute myeloid leukemia received DLI for conversion from recipient predominant to complete donor chimerism on Day +193 after allogeneic HSCT. Eight weeks later, she complained of dyspnea with fever; chest computed tomography revealed diffuse, bilateral, ground glass opacity and reticular appearance. She was diagnosed as having NIPC based on serum and bronchoalveolar lavage fluid (BALF) findings. She was successfully treated with prednisolone (PSL) and completely recovered.DISCUSSIONWe analyzed the cell profile from the BALF and 27 cytokines and chemokines in the serum using the Bio‐Plex platform. The cells consisted of recipient predominant macrophages and T cells. The serum cytokine and chemokine profile showed significant elevation of interleukin (IL)−1β, IL‐6, IL‐8, tumor necrosis factor‐α, macrophage inflammatory protein (MIP)−1α, and MIP‐1β, which declined with the improvement of symptoms after initiation of PSL treatment.CONCLUSIONInflammatory effectors by recipient cells, rather than allogeneic responses by donor cells, played an important role in the pathogenesis of NIPCs after DLI in the present case.