[TNF-alpha in allogeneic bone marrow transplantation. Significance for immunologic reconstitution, acute graft versus host disease and risk of complications after bone marrow transplantation].

Follow-up studies on the release of tumor necrosis factor-alpha (TNF-alpha) in 114 patients confirm that this cytokine is released early in the course of endothelial complications, acute graft-versus-host disease, and interstitial pneumonitis following allogeneic bone marrow transplantation. Possible sources of systemic TNF-alpha activity are, in particular, tissue macrophages of the recipient type that are stimulated by pretransplant conditioning and endotoxin and subsequently further activated by interferon gamma released by donor lymphocytes. Consideration of these interactions permits the early recognition of high-risk patients, and suggests new strategies for prophylaxis and treatment of complications.