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Inflammatory monocytes promote pre-engraftment syndrome and tocilizumab can therapeutically limit pathology in patients

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  • Linlin Jin

    (University of Science and Technology of China
    University of Science and Technology of China
    University of Science and Technology of China)

  • Zimin Sun

    (University of Science and Technology of China)

  • Huilan Liu

    (University of Science and Technology of China)

  • Xiaoyu Zhu

    (University of Science and Technology of China)

  • Yonggang Zhou

    (University of Science and Technology of China
    University of Science and Technology of China)

  • Binqing Fu

    (University of Science and Technology of China
    University of Science and Technology of China)

  • Xiaohu Zheng

    (University of Science and Technology of China
    University of Science and Technology of China)

  • Kaidi Song

    (University of Science and Technology of China)

  • Baolin Tang

    (University of Science and Technology of China)

  • Yun Wu

    (University of Science and Technology of China)

  • Jiang Zhu

    (University of Science and Technology of China)

  • Rui Sun

    (University of Science and Technology of China
    University of Science and Technology of China)

  • Zhigang Tian

    (University of Science and Technology of China
    University of Science and Technology of China
    University of Science and Technology of China)

  • Haiming Wei

    (University of Science and Technology of China
    University of Science and Technology of China
    University of Science and Technology of China)

Abstract

Unrelated cord blood transplantation (UCBT) is an effective treatment for hematopoietic disorders. However, this attractive approach is frequently accompanied by pre-engraftment syndrome (PES), severe cases of PES are associated with enhanced mortality and morbidity, but the pathogenesis of PES remains unclear. Here we show that GM-CSF produced by cord blood-derived inflammatory monocytes drives PES pathology, and that monocytes are the main source of IL-6 during PES. Further, we report the outcome of a single arm, single-center clinical study of tocilizumab in the treatment of steroid-refractory severe PES patients (www.chictr.org.cn ChiCTR1800015472). The study met the primary outcome measure since none of the patients was nonrelapse death during the 100 days follow-up. The study also met key secondary outcomes measures of neutrophil engraftment and hematopoiesis. These findings offer a therapeutic strategy with which to tackle PES and improve nonrelapse mortality.

Suggested Citation

  • Linlin Jin & Zimin Sun & Huilan Liu & Xiaoyu Zhu & Yonggang Zhou & Binqing Fu & Xiaohu Zheng & Kaidi Song & Baolin Tang & Yun Wu & Jiang Zhu & Rui Sun & Zhigang Tian & Haiming Wei, 2021. "Inflammatory monocytes promote pre-engraftment syndrome and tocilizumab can therapeutically limit pathology in patients," Nature Communications, Nature, vol. 12(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:12:y:2021:i:1:d:10.1038_s41467-021-24412-1
    DOI: 10.1038/s41467-021-24412-1
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