Evaluation of solubl HLA G and cytokine levels in children with acute leukemia and allogeneic stem cell transplantation

There are few studies about cytokines and sHLA-G levels in patients with acute leukemia undergoing allogeneic stem cell transplantation (allo-SCT). We aimed to investigate the role of cytokines and sHLA-G levels measured at 5 different time points in children with acute leukemia undergoing allo-SCT. A total of 41 patients were included in this study. These patients were diagnosed acute leukemia (n=41). According to the follow-up, 26 patients were examined during the diagnosis of acute leukemia (T) and in the remission period before transplantation (PreTx). The remaining 15 patients included on the day of transplantation (Tx0), a total of 41 patients with acute leukemia were also examined on the 14th (PostTx14) and 28th (PostTx28) days after transplantation. Proinflammatory (IL-1, IL-2, IL-6, TNF-α), anti-inflammatory (IL-4, IL-10) cytokines and sHLA-G levels were measured by ELISA method. The cytokine and sHLA-G levels in acute leukemia diagnosis (T) and post-transplantation periods (Tx0, PostTx14, PostTx28) were found to be significantly higher than the cytokine and sHLA-G levels in the pre-transplantation (PreTx) period (p<0.05). The cutoff values for cytokines and sHLA-G levels were calculated. Serum IL-2 and sHLA-G levels were significantly higher in children with T-ALL than in children with B-ALL (p<0.05). Serum IL-10 level was significantly higher in children with T-ALL than in children with AML (p<0.05). In the Tx0 and PostTx14 days, transplantation related complications and relapse risk were found to be approximately 2.5 times higher in patients with elevated cytokines and sHLA-G levels. In the Tx0 day, patients with high antiinflammatory cytokines increased mortality risk. Our results indicate that elevated proinflammatory and anti-inflammatory cytokines and sHLA-G levels are associated with transplantation related complications and relapse on the Tx0 day in children with acute leukemia, and also elevated proinflammatory cytokines have a negative effect on overall survival. Our findings need to be confirmed in a study with a larger number of leukemia patients.