Predicting the severity of intestinal graft-versus-host disease from leukotriene B4 levels after bone marrow transplantation

Abstract

Intestinal graft-versus-host disease (GVHD) produces clinical manifestations and histological changes resembling those of ulcerative colitis and has been treated with drugs which are used for ulcerative colitis. These two conditions also resemble each other with respect to changes of cytokines. Accordingly, we investigated whether the level of leukotriene B4, a risk factor for ulcerative colitis, was also a risk factor or prognostic indicator for intestinal GVHD. The pre-conditioning leukotoriene B4 level was significantly related to the grade of intestinal GVHD in 42 patients (P < 0.01). Compared with patients who did not develop severe intestinal GVHD after bone marrow transplantation, those who did had significantly higher interleukin-2 and interferon-γ levels during the aplastic phase (P <0.01), followed by higher tumor necrosis factor-α levels during the recovery phase (P < 0.0001), with significant elevation of tumor necrosis factor-α and interferon-γ occurring in association with exacerbations of intestinal GVHD (P < 0.001). These findings suggest a similarity between the pathogenesis of ulcerative colitis and intestinal GVHD and raise the possibility that leukotriene B4 may be a useful prognostic indicator for intestinal GVHD. Bone Marrow Transplantation (2000) 26, 1313–1316.