Clinical significance of B cell-activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

Jin Seok Kim; Soo-Jeong Kim; June-Won Cheong; Yundeok Kim; Doh Yu Hwang; Sulhee Yoon; Jieun Jang; Shin Young Hyun; Yoo Hong Min

doi:10.5045/kjh.2011.46.3.175

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Original Article

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Korean J Hematol 2011; 46(3):

Published online September 30, 2011

https://doi.org/10.5045/kjh.2011.46.3.175

Clinical significance of B cell-activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

Jin Seok Kim, Soo-Jeong Kim, June-Won Cheong, Yundeok Kim, Doh Yu Hwang, Sulhee Yoon, Jieun Jang, Shin Young Hyun, and Yoo Hong Min^*

Author Info. +

Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to : Correspondence to Yoo Hong Min, M.D., Ph.D. Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro (250 Seongsanno), Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-1956, Fax: +82-2-393-6884, minbrmmd@yuhs.ac

Received: July 3, 2011; Revised: August 2, 2011; Accepted: August 23, 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Abstract

Background

BAFF (B cell-activating factor) and APRIL (a proliferation-inducing ligand) are members of the tumor necrosis factor family and promote B cell survival and proliferation. We evaluated the correlation between serum concentration of BAFF or APRIL and severity of acute graft-versus-host disease (GVHD).

Methods

Fifteen patients who received allogeneic hematopoietic stem transplantation for leukemia and developed acute GVHD were enrolled. We determined serum concentrations of BAFF and APRIL at the onset of the first clinical manifestation of GVHD by enzyme-linked immunosorbent assay.

Results

Nine patients had grade 2 acute GVHD, and 6 had grade 3-4 acute GVHD. The BAFF serum concentration was higher in patients with grade 3-4 acute GVHD (1,093.42 in grade 2 vs. 2,171.99 pg/mL in grade 3-4), although the difference was not significant (P=0.077). However, the ratio of BAFF serum concentration to absolute lymphocyte count (ALC) (BAFF/ALC) was significantly higher in patients with grade 3-4 acute GVHD (P=0.045). The APRIL serum concentration and APRIL/ALC ratio showed similar results (P=0.077 and P=0.013, respectively).

Conclusion

Patients with grade 3-4 acute GVHD had higher BAFF/ALC and APRIL/ALC ratios than patients with grade 2 acute GVHD. These findings suggest that B cells might play an important role in the development of acute GVHD, and that the BAFF and APRIL concentrations in serum might be significant predictive factors for estimating the severity of acute GVHD. Their clinical significance should be further evaluated in a larger patient population.

Keywords B cell-activating factor (BAFF), A proliferation-inducing ligand (APRIL), Acute graft-versus-host disease, Allogeneic hematopoietic stem cell transplantation

Article

Original Article

Korean J Hematol 2011; 46(3): 175-179

Published online September 30, 2011 https://doi.org/10.5045/kjh.2011.46.3.175

Clinical significance of B cell-activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

Jin Seok Kim, Soo-Jeong Kim, June-Won Cheong, Yundeok Kim, Doh Yu Hwang, Sulhee Yoon, Jieun Jang, Shin Young Hyun, and Yoo Hong Min^*

Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to: Correspondence to Yoo Hong Min, M.D., Ph.D. Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro (250 Seongsanno), Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-1956, Fax: +82-2-393-6884, minbrmmd@yuhs.ac

Received: July 3, 2011; Revised: August 2, 2011; Accepted: August 23, 2011

Abstract

Background

Methods

Results

Conclusion

Keywords: B cell-activating factor (BAFF), A proliferation-inducing ligand (APRIL), Acute graft-versus-host disease, Allogeneic hematopoietic stem cell transplantation

Abstract

Table 1 . Patient characteristics..

Abbreviations: AML, acute myelogenous leukemia; ALL, acute lymphoblastic leukemia; CML, chronic myelogenous leukemia; TBI, total body irradiation..

Table 2 . Serum BAFF and APRIL levels and acute GVHD characteristics..

^a)Onset date of acute GVHD after allogeneic HSCT, ^b)Laboratory results at the diagnosis of acute GVHD..

Abbreviations: AML, acute myelogenous leukemia; ALL, acute lymphoblastic leukemia; CML, chronic myelogenous leukemia; M, male; F, female; GVHD, graft-versus-host disease; ALC, Absolute lymphocyte count; BAFF, B cell-activating factor; APRIL, a proliferation-inducing ligand..

Table 3 . Serum BAFF and APRIL levels according to grade of acute GVHD..

Abbreviations: GVHD, graft-versus-host disease; ALC, Absolute lymphocyte count; BAFF, B cell-activating factor; APRIL, a proliferation-inducing ligand; NS, not significant..