• VisentainerJeane Eliete LaguilaJEUniversidade Estadual de Campinas, Campinas, São Paulo, Brazil. jelvisentainer@ibest.com.br, Sofia Rocha Lieber, L gia Beatriz Lopes Persoli, Afonso Celso Vigorito, Francisco Jos Penteado Aranha, and C rmino Antonio de Souza.
• Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. jelvisentainer@ibest.com.br
• Sao Paulo Med J. 2002 Nov 1; 120 (6): 175179175-9.

ContextMixed lymphocyte culturing has led to conflicting opinions regarding the selection of donors for bone marrow transplantation. The association between a positive mixed lymphocyte culture and the development of graft-versus-host disease (GVHD) is unclear. The use of exogenous cytokines in mixed lymphocyte cultures could be an alternative for increasing the sensitivity of culture tests.ObjectiveTo increase the sensitivity of mixed lymphocyte cultures between donor and recipient human leukocyte antigen (HLA) identical siblings, using exogenous cytokines, in order to predict post-transplantation GVHD and/or rejection.Type Of StudyProspective study.SettingBone Marrow Transplantation Unit, Universidade Estadual de Campinas.ParticipantsSeventeen patients with hematological malignancies and their respective donors selected for bone marrow transplantation procedures.ProceduresStandard and modified mixed lymphocyte culturing by cytokine supplementation was carried out using donor and recipient cells typed for HLA.Main MeasurementsAutologous and allogenic responses in mixed lymphocyte cultures after the addition of IL-4 or IL-2.ResultsIn comparison with the standard method, average responses in the modified mixed lymphocyte cultures increased by a factor of 2.0 using IL-4 (p < 0.001) and 6.4 using IL-2 (p < 0.001), for autologous donor culture responses. For donor-versus-recipient culture responses, the increase was by a factor of 1.9 using IL-4 (p < 0.001) and 4.1 using IL-2 (p < 0.001). For donor-versus-unrelated culture responses, no significant increase was observed using IL-4, and a mean response inhibition of 20% was observed using IL-2 (p < 0.001). Neither of the cytokines produced a significant difference in the unrelated control versus recipient cell responses.ConclusionIL-4 supplementation was the best for increasing the mixed lymphocyte culture sensitivity. However, IL-4 also increased autologous responses, albeit less intensively than IL-2. Thus, with this loss of specificity we believe that it is not worth modifying the traditional mixed lymphocyte culture method, even with IL-4 addition.

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