DIE BEDEUTUNG DES INTERLEUKIN 10 FUR DIE AKUTE GRAFT VERSUS HOST ERKRANKUNG BEI KINDERN UND JUGENDLICHEN NACH ALLOGENER KNOCHENMARKTRANSPLANTATION

Background: It has been shown that Interleukin 10 (IL-10) is able to inhibit alloreactivity in a mixed lymphocyte culture. Therefore, here IL-10 production in patients after allogeneic BMT was investigated and correlated with the incidence of acute GvHD. Patients: 14 patients after allogeneic BMT have been investigated. Patients' age ranged from 2.6 to 22 yrs (median 7 yrs). Patients were diagnosed with Ewing's sarcoma (1), ALL (4), AML (3), CML (2), Wiskott-Aldrich Syndrome (WAS; 1), MDS (1) and SAA (2). GvHD > II° occurred in 5/14 patients. As control served 20 healthy volunteers. Methods: Mononuclear cells (MNC's) isolated from patients and 20 healthy controls were stimulated with an anti-CD3 monoclonal antibody for 72 hr. IL-10 was detected in cell-free supernatants by ELISA. Results: Anti-CD3-induced IL-10 production in MNC's isolated from patients (range/median: 0-1579 pg/10⁶ MNC; 221 pg/10⁶ MNC) was significantly reduced compared to healthy controls (160-5093 pg/10⁶ MNC; 1250 pg/10⁶ MNC; p < 0.01). 4/5 patients with low IL-10 production, but only 1/9 with a normal IL-10 production presented with GvHD > II° (p < 0.05). Conclusion: Ex vivo IL-10 production was decreased in about one third of patients early after allogeneic BMT. The low IL-10 production was associated with a significantly increased risk of severe GVHD. Thus, supplementation of IL-10 might become a useful therapy to prevent GvHD.