Graft-versus-host disease (GVHD) remains a major complication after allogeneic hematopoietic cell transplantation (HCT) and is associated with increased nonrelapse mortality in patients. Researchers evaluated the serum protein levels of patients who underwent HCT to find predictive markers for the development of severe acute GVHD (aGVHD).
In their study, published in BMC Cancer, the authors reported that high levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) at baseline and at 2 weeks may serve as a predictive biomarker for aGVHD in recipients of HCT.
The study included 30 patients (46.7% male; median years of age, 53.5 [range, 19-69]) who underwent HCT at the authors’ center between 2017 and 2019. Underlying conditions included acute myeloid leukemia (n=9), acute lymphoblastic leukemia (n=6), myelodysplastic syndrome (n=7), aplastic anemia (n=4), and myelofibrosis (n=4). Researchers collected cell-free serum samples 1 week prior to HCT, the day of HCT, and at 1 and 2 weeks following HCT.
[Heading 3] Soluble Vascular Cell Adhesion Molecule-1 Predicts aGVHD
According to the report, any grade aGVHD occurred in 21 patients (70.0%), and grade II-IV aGVHD occurred in 17 patients (56.7%). Compared with baseline levels 1 week prior to HCT, patients with aGVHD had significantly increased plasma beta 2-microglobulin (β2-MG; P=.028) and sVCAM-1 (P<.001) at 2 weeks post-HCT.
Additionally, the authors found that patients with grade II-IV severe aGVHD had significantly higher sVCAM-1 levels both 1 week prior to HCT and 2 weeks after compared with patients with grade I aGVHD (P=.028) or with no aGVHD (P=.035).
The full article notes the study was limited by a small number of enrolled patients and by comparisons of patients with GVHD with patients with no GVHD, which the authors acknowledged may have increased the chance of identifying a suboptimal biomarker.
Nonetheless, the authors suggested that “a higher sVCAM-1 level at preconditioning baseline and at day 14+ after HCT is a potentially useful biomarker to predict the development of severe aGVHD in the early period of HCT.”