Biomarkers of Chronic Graft-Versus-Host Disease in a Pediatric Cohort

By Dustin Samples - February 22, 2023

A team of researchers and clinicians in British Columbia, Canada, examined the blood plasma metabolome changes in a cohort of pediatric patients with chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). The first author, Tashi Rastogi, presented their results at the 2023 Tandem Transplant & Cellular Therapy Meetings of the ASTCT and CIBMTR.

The team used archival samples from the Children’s Oncology Group trial #ASCT0031, which enrolled 75 pediatric patients at the onset of cGVHD. Plasma from whole blood samples was analyzed for approximately 142 metabolites via direct-injection mass spectrometry with reverse-phase LC-MS/MS, and the differences between levels in patients with cGVHD (n=38) and non-cGVHD (n=37) were compared.

In patients with cGVHD, the research team found “significant increases in α-ketoglutarate and glutamic acid, and close to a significant increase in kynurenine at onset,” as well as “significant decreases in glutamine,” which is generally inversely correlated with glutamic acid.

While the team seems to have expected those results, they were more surprised at what they did not observe, stating, “secondary metabolome changes, such as an elevation in 18:0SM and decreases in p-hydroxyhippuric acid and acetyl-ornithine were not found in this data.”

The lack of secondary metabolome changes contradicts findings from a previous study, as does their observation that C8 was “significantly increased in this cohort.”

Rastogi T, Ng B, Johnston L, et al. Validating Alpha-Ketoglutarate As a Biomarker for Chronic Graft-Versus-Host Disease in a Separate Pediatric Cohort. Abstract #348. Presented at the 2023 Tandem Meetings of ASTCT and CIBMTR; February 15-19, 2023; Orlando, FL.

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