Cytokines and Cytomegalovirus Disease Following Allogeneic Bone Marrow Transplantation

Cytomegalovirus (CMV) disease (interstitial pneumonia and encephalitis) is an important complication of bone marrow transplantation. We monitored cytokine, adhesion molecule, and chemokine levels from before conditioning until the early stage after allogeneic bone marrow transplantation in 15 procedures where recipients or donors were seropositive for CMV. Results were compared between the patients with symptomatic, asymptomatic CMV, and no CMV. All four patients with CMV disease had fever during the aplastic phase after bone marrow transplantation and all of them showed a marked increase of tumor necrosis factor-α, interferon-γ, and interleukin-8 at the time of leukocyte recovery (p<0.05; two-way layout analysis of variance). Patients without CMV disease despite of reactivation of the virus, showed a significant increase of interferon-γ p<0.05; two-way layout analysis of variance), but there was no rise of tumor necrosis factor-a or interleukin-8. Cytomegalovirus-negative patients showed no increase of any of these cytokines. Elevation of these three cytokines may cause CMV replication, and inflammation during the aplastic phase may promote such a cytokine increase. Our findings suggest that a marked increase of interferon-γ, tumor necrosis factor-α, and interleukin-8 during engraftment after bone marrow transplantation may be related to CMV disease.