High day 28 ST2 levels predict for acute graft-versus-host disease and transplant-related mortality after cord blood transplantation

Doris M. Ponce, Patrick Hilden, Christen Mumaw, Sean M. Devlin, Marissa Lubin, Sergio Giralt, Jenna D. Goldberg, Alan Hanash, Katharine Hsu, Robert Jenq, Miguel Angel Perales, Craig Sauter, Marcel R.M. Van Den Brink, James W. Young, Renier Brentjens, Nancy A. Kernan, Susan E. Prockop, Richard J. O'Reilly, Andromachi Scaradavou, Sophie PaczesnyJuliet N. Barker

Research output: Contribution to journalArticle

63 Scopus citations


While cord blood transplantation (CBT) is an effective therapy for hematologic malignancies, acute graft-versus-host disease (aGVHD) is a leading cause of transplant-related mortality (TRM). We investigated if biomarkers could predict aGVHD and TRM after day28 in CBT recipients. Day 28 samples from 113 CBT patients were analyzed. Suppressor of tumorigenicity 2 (ST2) was the only biomarker associated with grades II-IV and III-IV aGVHD and TRM. Day 180 grade III-IV aGVHD in patients with high ST2 levels was 30% (95% confidence interval [CI], 18-43) vs 13% (95% CI, 5-23) in patients with low levels (P=.024). The adverse effect of elevated ST2 was independent of HLA match. Moreover, high day 28 ST2 levels were associated with increased TRM with day 180 estimates of 23%(95% CI, 13-35) vs 5% (95% CI, 1-13) if levels were low (P = .001). GVHD was the most common cause of death in high ST2 patients. High concentrations of tumor necrosis factor receptor-1, interleukin-8, and regenerating islet-derived protein 3-α were also associated with TRM. Our results are consistent with those of adult donor allografts and warrant further prospective evaluationt of acilitate future therapeutic intervention to ameliorate severe aGVHD and further improve survival after CBT.

Original languageEnglish (US)
Pages (from-to)199-205
Number of pages7
Issue number1
StatePublished - Jan 1 2015


ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Ponce, D. M., Hilden, P., Mumaw, C., Devlin, S. M., Lubin, M., Giralt, S., Goldberg, J. D., Hanash, A., Hsu, K., Jenq, R., Perales, M. A., Sauter, C., Van Den Brink, M. R. M., Young, J. W., Brentjens, R., Kernan, N. A., Prockop, S. E., O'Reilly, R. J., Scaradavou, A., ... Barker, J. N. (2015). High day 28 ST2 levels predict for acute graft-versus-host disease and transplant-related mortality after cord blood transplantation. Blood, 125(1), 199-205. https://doi.org/10.1182/blood-2014-06-584789