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Cytokine levels following allogeneic hematopoietic cell transplantation: a match-pair analysis of home care versus hospital care

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Abstract

Following allogeneic hematopoietic cell transplantation (HCT), patients living near the hospital were treated at home instead of in isolation in the hospital. We analyzed cytokines using Luminex assays for the first 3 weeks after HCT and compared patients treated at home (n = 42) with matched patients isolated in the hospital (n = 37). In the multivariate analysis, patients treated at home had decreased GM-CSF, IFN-γ (p < 0.01), IL-13, IL-5 (p < 0.05), and IL-2 (p < 0.07). Bloodstream infections, anti-thymocyte globulin, G-CSF treatment, immunosuppression, reduced-intensity conditioning (RIC), related vs. unrelated donors, and graft source affected various cytokine levels. When patients with RIC were analyzed separately, home care patients had reduced G-CSF (p = 0.04) and increased vascular endothelial growth factor (VEGF, p = 0.001) at 3 weeks compared with hospital care patients. Patients with low GM-CSF (p < 0.036) and low IFNγ (p = 0.07) had improved survival. Acute GVHD grades III–IV was seen in 7% and 16% of home care and hospital care patients, respectively. One-year transplantation-related mortality was 7% and 16% and survival at 5 years was 69% and 57% in the two groups, respectively. To conclude, patients treated in the hospital showed varying increased levels of GM-CSF, IFN-γ, IL-13, G-CSF, IL-5, and IL-2 and decreased VEGF, which may contribute to acute GVHD.

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Acknowledgements

We would like to thank Gunilla Tillinger for typing this manuscript. OR was supported by grants from the Swedish Cancer Society, (CAN 2018/671), the Swedish Research Council (K2014-64X-05971-34-4) and the Cancer Society in Stockholm (111293). MR was supported by grants from the Swedish Research Council (2017/00355). OR was supported by a Distinguished Professor Award from the Karolinska Institutet.

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Authors and Affiliations

  1. Translational Cell Therapy Research Group (TCR), Department of Pediatrics, CLINTEC, Karolinska Institutet, Kliniskt Forskningscentrum, KFC, NOVUM Plan 6, Hälsovägen 7-9, 141 57, Huddinge, Sweden

    Olle Ringdén, Britt-Marie Svahn & Behnam Sadeghi

  2. Department of Medical Sciences, Uppsala University and KFUE, Uppsala University Hospital, Uppsala, Sweden

    Mats Remberger

  3. Cell Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden

    Johan Törlén & Sigrun Finnbogadottir

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  1. Olle Ringdén
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Ringdén, O., Remberger, M., Törlén, J. et al. Cytokine levels following allogeneic hematopoietic cell transplantation: a match-pair analysis of home care versus hospital care. Int J Hematol 113, 712–722 (2021). https://doi.org/10.1007/s12185-021-03087-w

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