Prognostic biomarkers for acute graft-versus-host disease risk after cyclophosphamide-fludarabine nonmyeloablative allotransplantation

Robert P. Nelson, Muhammad Rizwan Khawaja, Susan M. Perkins, Lindsey Elmore, Christen L. Mumaw, Christie Orschell, Sophie Paczesny

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Five candidate plasma biomarkers (suppression of tumorogenesis 2 [ST2], regenerating islet-derived-3α [REG3α], elafin, tumor necrosis factor receptor 1 [TNFR1], and soluble IL-2 receptor-alpha [sIL2Rα]) were measured at specific time points after cyclophosphamide/fludarabine-based nonmyeloablative allotransplantation (NMAT) in patients who did or did not develop acute graft-versus-host disease (aGVHD). Plasma samples from 34 patients were analyzed at days+7,+14,+21, and+30. At a median follow-up of 358days, 17 patients had experienced aGVHD with a median time to onset at day+36. Risk of aGVHD wasassociated with elevated plasma ST2 concentrations at day+7 (c-statistic=72, P=03), day+14 (c-statistic=74, P=02), and day+21 (c-statistic=75, P=02); elevated plasma REG3α concentrations at day+14 (c-statistic=73, P=03), day+21 (c-statistic=76, P=01), and day+30 (c-statistic=73, P=03); and elevated elafin at day+14 (c-statistic=71, P=04). Plasma concentrations of TNFR1 and sIL2Rα were not associated with aGVHD risk at any of the time points studied. Thisstudy identified ST2, REG3α, and elafin as prognostic biomarkers to evaluate risk of aGVHD after cyclophosphamide/fludarabine-based NMAT. These results need to be confirmed in an independent validation cohort.

Original languageEnglish (US)
Pages (from-to)1861-1864
Number of pages4
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number11
DOIs
StatePublished - Nov 1 2014

Keywords

  • Acute graft-versus-host-disease
  • Biomarkers
  • Nonmyeloablative allotransplantation

ASJC Scopus subject areas

  • Transplantation
  • Hematology
  • Medicine(all)

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