TNFR1 factor
By examining TNFR ratio on days 7, 14, 21 and 28 compared to pre-transplantation, it was observed that this level was enhanced in both MSCs + HSC and HSC groups on day 7 which could be caused by conditioning regimens. Since TNF-α is one of the most important factors of inflammation, following mucosal and subsequent epithelium injury and initiation of inflammatory pathways, the alternative marker of this inflammatory factor also increases in the plasma of transplanted patients. In the mesenchymal stem cell recipient group, this ratio decreased earlier than in the HSCs alone. However, there was no significant difference in the ratio of TNFR1 on different days between two groups (Table.5)
According to Table 6 (considering p value: 0.05) both groups showed there was no significant difference in mean values of TNFR between two groups on different days.
DNAM-1 factor
Due to the important role of the interaction between DNAM-1 and its ligand in the development of aGvHD, patients with higher DNAM-1 levels are assumed to exhibit higher GvHD. All patients selected for this study had a DNAM-1 level higher than 8 ng/ml at baseline (above the mean in normal subjects). Based on previous studies and the prognostic role of this marker in the incidence of GvHD, patients with higher level of DNAM-1 were selected for co-transplantation of MSCs and HSCs. According to Table no. 7, comparing the mean DNAM factor for each day in two groups, a significant difference is shown on day 7 with P-VALUE equal to 0.03 and less than 0.05. But in other days we did not see a significant difference between two groups with P-VALUE higher than 0.05( Figure 5).