Predictive Values of Early Suppression of Tumorigenicity 2 for Acute GVHD and Transplant-related Complications After Allogeneic Stem Cell Transplantation: Prospective Observational Study

Overview

Journal Turk J Haematol

Specialty Hematology

Date 2019 Aug 30

PMID 31464120

Authors

Ayako Matsumura

Takuya Miyazaki

Takayoshi Tachibana

Taiki Ando

Megumi Koyama

Satoshi Koyama

Yoshimi Ishii

Hiroyuki Takahashi

Yuki Nakajima

Ayumi Numata

Wataru Yamamoto

Kenji Motohashi

Maki Hagihara

Kenji Matsumoto

Shin Fujisawa

Hideaki Nakajima

Affiliations

Soon will be listed here.

Abstract

Objective: A soluble form of suppression of tumorigenicity 2 (sST2) has emerged as a biomarker for acute graft-versus-host disease (GVHD) and non-relapse mortality (NRM). We prospectively monitored sST2 levels during the early phase of hematopoietic stem cell transplantation (HSCT) and evaluated the clinical association with transplant-related complications including acute GVHD.

Materials And Methods: Thirty-two adult Japanese patients who received a first allogeneic HSCT were enrolled in this study. Levels of sST2 were measured at fixed time points (pre-conditioning, day 0, day 14, day 21, and day 28).

Results: The median age was 50.5 years (range=16-66). With a median follow-up of 21.5 months (range=0.9-35.4), 9 patients developed grade II-IV acute GVHD. Median sST2 levels on the day of HSCT were higher than baseline and reached the maximum value (92.7 ng/mL; range=0-419.7) on day 21 after HSCT. The optimal cut-off value of sST2 on day 14 for predicting grade II-IV acute GVHD was determined as 100 ng/mL by ROC analysis. The cumulative incidence of acute GVHD was 56.7% and 16.5% in the high- and low-sST2 groups, respectively (p<0.01). Multivariate analyses showed that high sST2 levels at day 14 were associated with a higher incidence of acute GVHD (hazard ratio=9.35, 95% confidence interval=2.92-30.0, p<0.01). The cumulative incidence of NRM was increased in the highs-ST2 group (33% vs 0%, p<0.01), but all the patients died of non-GVHD complications. Among 6 patients in the high-sST2 group without grade II-IV GVHD, 5 patients developed veno-occlusive disease (VOD) and one also had thrombotic microangiopathy (TMA).

Conclusion: The early assessment of sST2 after HSCT yielded predictive values for the onset of acute GVHD and other transplant-related complications including VOD and TMA.

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