This prospective, multi-center study confirmed the correlation of plasma-derived proteins, previously assessed only in single-center cohorts, with the potential to improve diagnosis, assess risk and manage complications after allogeneic HCT.
The researchers measured biomarkers from plasma samples collected from 211 patients using enzyme-linked immunosorbent assays. All transplant patients in the study received uniform GVHD prophylaxis and conditioning regimens.
A multivariate analysis found that high levels of tumorigenicity-2 (ST2) and T-cell immunoglobulin mucin-3 (TIM3) at day 28 correlated with significantly higher risk of 2-year non-relapse mortality (p=0.005, p=0.0075, respectively). High levels of ST2, TIM3, IL-6 and Reg3α at day 180 were correlated with lower 2-year overall survival. In addition, low L-Ficolin was significantly associated with hepatic veno-occlusive disease (p=0.0053, AUC=0.80).
The researchers suggest that more frequent sample collection early after transplant is crucial for future biomarker studies to assess acute GVHD correlation, such as the ongoing Blood and Marrow Transplant Clinical Trials Network trial (BMT CTN 1202), a multi-center biomarker study that is collecting weekly samples starting at day 0.
Future trials should include biomarkers in risk-stratification models. This model is being tested in an upcoming BMT CTN prospective multi-center clinical trial (BMT CTN 1501).