ABSTRACTcytokine SFC in patients following HSCT and correlated the results with clinical findings. Furthermore, expression of CD29 (b1 integrin) on monocytes was correlated with plasma levels of fibronectin in patients with active chronic GVHD.
Design and Methods
PatientsFifty-seven patients who underwent allogeneic HSCT between 1995 and 2009 were included in this study. The patients' demographic data are shown in Table 1. Sixteen patients with chronic GVHD were grouped into mild (n=7), moderate (n=8), and severe (n=1) categories based on the NIH chronic GVHD consensus criteria. 5 According to Sarantopoulos's definition of chronic GVHD activity, patients were subclassified into those with no, active, and inactive chronic GVHD. 28 Patients who never developed chronic GVHD (n=41) were designated as "no chronic GVHD". Patients with active chronic GVHD (n=14) were more likely to be receiving immunosuppressive therapy. Inactive chronic GVHD (n=10) was determined by clinical assessment and included patients who had achieved a complete response to immunosuppressive therapy at the time of analysis. The number of patients with active and inactive chronic GVHD overlapped during the clinical course. Disease activity was assessed without knowledge of the laboratory results. The median time of the analysis was 48 (range, 4-204), 52 (5-142), and 55 (4-151) months after transplantation for patients with no, active, and inactive chronic GVHD, respectively.This study was conducted according to the principles expressed in the Declaration of Helsinki and approved by the Institutional Ethics Committee Review Board at Mie University Hospital. The study was registered with the national regulatory authority (UMIN-Clinical Trials Registry). All participants or their guardians provided written informed consent for the collection of samples and subsequent analyses.
Diagnosis of chronic graft-versus-host disease and processing of samplesThe diagnosis of chronic GVHD requires the presence of at least one diagnostic manifestation of the disease or at least one distinctive manifestation, with the diagnosis confirmed by pertinent biopsy, laboratory tests, or radiology in the same or another organ.5,29 Diagnostic manifestations of chronic GVHD were found in the skin, nails, mouth, eyes, lungs, gastrointestinal tract, and liver. The grade of chronic GVHD was determined according to NIH consensus criteria. 5,30 Peripheral blood mononuclear cells (PBMC) were obtained from patients with no evidence of infection, and the diagnoses were confirmed by laboratory testing or radiology, at least 100 days after allogeneic HSCT. The total numbers of white blood cells, lymphocytes, and monocytes were analyzed by an automatic blood cell counter (Sysmex K4500, Toa Medical Electronics, Tokyo, Japan).
Flow cytometry and cell separationCells were stained with fluorescein-conjugated monoclonal antibodies to human anti-CD3, CD4, CD8, CD11c, CD16, CD19, CD25, CD29, CD33, CD56, CD123 (BD Biosciences, San Jose, CA, USA), CD14 (Beckman Coulter, CA, USA), CD68, interle...