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Cytokine mRNA profiles in Epstein–Barr virus‐associated post‐transplant lymphoproliferative disorders

Cytokine mRNA patterns were analyzed in 11 post‐transplant lymphoproliferative disorder (PTLD) specimens using qualitative reverse‐transcriptase polymerase chain reaction (RT‐PCR). In each case, a pattern of IL2−, IFNΓ−, IL4+, IL10+ was seen. A similar pattern was observed in a spleen sample from 1 patient with contemporaneous PTLD elsewhere. Semiquantitative RT‐PCR for cytokine message was performed using RNA from bronchoalveolar lavage (BAL) specimens obtained from 2 patients with pulmonary PTLD. In both cases, IL4 message predominated. Reduction of message coincided with resolution of the tumors. The pattern differed from that seen in 1 patient with acute pulmonary rejection, in which RT‐PCR of BAL cells showed predominance of IL6 and IFNΓ. We conclude that at least some PTLDs exist within a T‐helper cell type 2 (Th2)‐like cytokine microenvironment. The presence of a similar mRNA pattern in an extratumoral specimen at the time of PTLD suggests that it may reflect a systemic phenomenon. Disappearance of this pattern following PTLD resolution indicates its dynamic nature and is consistent with the hypothesis that specific cytokines contribute to the development of PTLDs.