There are no validated biomarkers for chronic GVHD (cGVHD). We used a protein microarray and subsequent sequential enzyme-linked immunosorbent assay to compare 17 patients with treatment-refractory de novo-onset cGVHD and 18 time-matched control patients without acute or chronicGVHDto identify 5 candidate proteins that distinguished cGVHD from no cGVHD: CXCL9, IL2Ra, elafin, CD13, and BAFF. We then assessed the discriminatory value of each protein individually and in composite panels in a validation cohort (n5109). CXCL9wasfoundtohavethehighest discriminatory valuewithanareaunder the receiver operating characteristic curve of 0.83 (95% confidence interval, 0.74-0.91).CXCL9 plasma concentrations above the median were associatedwith a higher frequency of cGVHD even after adjustment for other factors related todevelopingcGVHDincludingage, diagnosis, donor source, and degree of HLA matching (71% vs 20%; P > .001). A separate validation cohort from a different transplant center (n 5 211) confirmed that CXCL9 plasma concentrations abovethemedianwereassociatedwithmorefrequentnewlydiagnosedcGVHDafteradjustingfo r theaforementionedfactors (84% vs 60%; P 5 .001). Our results confirmthat CXCL9 is elevated in patients with newly diagnosed cGVHD.
ASJC Scopus subject areas
- Cell Biology