The underlying biology of engraftment syndrome (ES) following allogeneic hematopoietic stem cell transplantation (HSCT) is not fully elucidated, and the extent of its overlap with acute graft-versus-host disease (aGvHD) remains unclear. In order to establish potential indicator to distinguish ES more accurately, we conducted a retrospective analysis of cytokine levels during HSCT. A total of 121 consecutive adult patients who underwent HSCT were enrolled in this study. Blood samples for interleukin (IL)-2, IL-2R, IL-4, IL-5, IL-6, IL-8, IL-10, IL-1β, IL-12p70, interferon (IFN)-γ, IFN-α, tumor necrosis factor alpha (TNF-α) and C-reactive protein CRP were regularly assessed after transplantation and during transplantation related adverse events. Additionally, the balance of naïve, central memory and effector memory of CD4 and CD8 was analyzed around 30 and 60 days after stem cell infusion, respectively. Thirty (24.79 %) and 33 (27.27 %) patients were diagnosed with ES and aGvHD, respectively. ES was characterized by a significant increase in level of IL-5, IL-6, IL-8 and sIL-2R, while aGvHD was associated with a significant upregulation of IL-6, IL-5, IL-10 and sIL-2R in the patients from grade I to grade IV. Notably, patients got much higher levels of IL-6, IL-5 and sIL-2R when developed to ES than to aGvHD. Moreover, a pronounced shift from naïve to memory cells, both in CD4 and CD8 subsets, was found in ES patients. These findings suggest that cytokine profiles could serve as potential indicators for detecting and differentiating ES and aGvHD, enabling timely clinical intervention. Prospective clinical trials involving larger, independent patient cohorts are required to validate these observations.

中文翻译：

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造血干细胞移植后成年患者植入综合征和急性移植物抗宿主病期间的血清细胞因子谱

异基因造血干细胞移植（HSCT）后植入综合征（ES）的潜在生物学机制尚未完全阐明，其与急性移植物抗宿主病（aGvHD）的重叠程度仍不清楚。为了建立更准确区分ES的潜在指标，我们对HSCT期间的细胞因子水平进行了回顾性分析。本研究共有 121 名连续接受 HSCT 的成年患者入组。血液样本中的白细胞介素 (IL)-2、IL-2R、IL-4、IL-5、IL-6、IL-8、IL-10、IL-1β、IL-12p70、干扰素 (IFN)-γ、IFN移植后和移植期间相关不良事件定期评估-α、肿瘤坏死因子α（TNF-α）和C反应蛋白CRP。此外，分别在干细胞输注后 30 天和 60 天左右分析了 CD4 和 CD8 的幼稚记忆、中枢记忆和效应记忆的平衡。分别有 30 名 (24.79%) 和 33 名 (27.27%) 患者被诊断为 ES 和 aGvHD。 ES 的特点是 IL-5、IL-6、IL-8 和 sIL-2R 水平显着升高，而 aGvHD 与 IL-6、IL-5、IL-10 和 sIL-2R 显着上调相关患者从I级到IV级。值得注意的是，发展为 ES 的患者比发展为 aGvHD 时的 IL-6、IL-5 和 sIL-2R 水平要高得多。此外，在 ES 患者中发现 CD4 和 CD8 亚群从幼稚细胞到记忆细胞的明显转变。这些发现表明细胞因子谱可以作为检测和区分 ES 和 aGvHD 的潜在指标，从而实现及时的临床干预。需要涉及更大的独立患者队列的前瞻性临床试验来验证这些观察结果。