Biomarker IDs Tx-Resistant Graft-Versus-Host Disease
(HealthDay News) – In patients with graft-versus-host disease (GVHD) after allogeneic hematopoietic stem-cell transplantation, levels of a particular biomarker can help identify patients at higher risk of treatment-resistant GVHD and death, according to a study published in the Aug. 8 issue of the New England Journal of Medicine.
Mark T. Vander Lugt, MD, from the University of Michigan in Ann Arbor, and colleagues measured the levels of 12 biomarkers in plasma from 10 patients who had a complete response to acute GVHD treatment and 10 patients with progressive GVHD during treatment. Samples were obtained a median of 16 days after initiating treatment. Levels of the lead biomarker were then measured in 381 patients at GVHD treatment initiation and in 673 patients during the first month after transplantation.
The researchers found that levels of suppression of tumorigenicity 2 (ST2) were most significantly associated with outcome. Patients with high levels of ST2 at treatment initiation were significantly more likely to have treatment-resistant GVHD (odds ratio, 2.3) and significantly more likely to die within six months after therapy (odds ratio, 3.7). Patients with low levels of ST2 had significantly lower mortality without relapse, regardless of GVHD grade. ST2 levels 14 days after transplantation were associated with six-month mortality without relapse.
"ST2 levels measured at the initiation of therapy for GVHD and during the first month after transplantation improved risk stratification for treatment-resistant GVHD and death without relapse after transplantation," Vander Lugt and colleagues conclude.