Determination of eosinophilic cationic protein and tryptase in graft versus host disease and hematological malignancies with eosinophilia

Diseases with eosinophilia the pathogenesis of which is unclear are of particular clinical significance among hematological malignancies. These include acute and chronic graft versus host disease (GVHD) associated with eosinophilia, hypereosinophilic syndrome and chronic myeloid leukemias, Hodgkin's and non-Hodgkin's lymphomas. The role of eosinophils and mast cells intracellular proteins in proliferative diseases is unknown. The objective of the investigation was to study the significance of tryptase and eosinophilic cationic protein (ECP) measurements in patients with chronic GVHD and hematological malignancies. Thirty two patients with verified oncohematological diseases (a study group) — 6 patients with chronic GVHD after allogeneic hemopoietic stem cells transplantation, 18 with asthma and 8 with solid tumors - were included in the study. The serum concentrations of tryptase and ECP were measured by immunofluorescence assay. Elevated ECP levels were found in patients with GVHD (p < 0.03) and in those with lymphoproliferative diseases (p = 0.007) as compared to the nonhematological group (p < 0.03). Increased tryptase level was recorded in patients with GVHD and lymphoproliferative diseases as compared to those with solid tumors and nonhematological disorders (p = 0.03), as well as in the GVHD versus lymphoproliferation groups (p < 0.05). A direct correlation between ECP concentration and the eosinophils count in patients with lymphoproliferative diseases (r = 0.9; p = 0.000001) was found. The authors have concluded that measurement of soluble eosinophilic proteins levels and mast cell enzymes is reasonable to diagnostics and monitoring of various hypereosinophilic states in patients with chronic GVHD and hematological malignancies.