A prognostic score based on the blood plasma concentration of three biomarkers can guide risk-adapted therapy at the onset of graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation (HCT). Researchers used the blood plasma-derived concentrations in 492 patients of three recently validated biomarkers (TNFR1, ST2, and REG3α) to create an algorithm that calculated the severity of GVHD based on the probability of non-relapse mortality (NRM) 6 months after GVHD onset. The algorithm computed three GVHD scores, which were independently validated using 300 additional HCT patients enrolled in Blood and Marrow Transplant Clinical Trial Network (BMT CTN) clinical trials of primary therapy for acute GVHD. Overall, the cumulative incidence of NRM in each the cohorts significantly increased as the calculated probability score increased (p<0.0001). The researchers concluded that these scores can be used to identify those patients with higher-risk GVHD who could receive aggressive intervention and those patients with low-risk GVHD who could benefit from a less-aggressive approach.
Levine JE, et al. Lancet Haematol
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