Involvement of TNF-alpha secreting macrophages in lethal forms of human graft-versus-host disease

We report three patients with lethal forms of acute GVHD in whom all biopsy specimens showed a striking preponderance of macrophages in the inflammatory infiltrate with production of TNF-alpha. The role of the macrophage/TNF-alpha axis in human acute GVHD is examined and the existence of primary macrophagic forms of GVHD is discussed.