Increased Serum Levels of Tumor Necrosis Factor a ! Precede Major Complications of Bone Marrow Transplantation

Acute graft-versus-host disease, interstitial pneumonitis, endothelial leakage syndrome, and veno-occlusive disease are major complications of bone marrow transplantation. Though several new regimens for prophylaxis and treatment of these syndromes have been introduced, the overall incidence has been only slightly reduced over the last few years. We retrospectively analyzed tumor necrosis factor alpha (TNFa) serum levels between day -8 and day 100 after bone marrow transplantation in 56 patients transplanted in our unit for a variety of hematological diseases. In 34 patients with uneventful courses, mean TNFa levels rose to a maximum of 76 k 29 pg/mL. In contrast, 22 patients with major transplant related complications showed

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