Table 1.
Summary of biomarkers in acute GvHD.
| Biomarker | Study | Use | Cohort | Findings |
|---|---|---|---|---|
| ST2 | Vander et al. (17) | Predictive | First 3m post-transplantation in 673 patients, at start of GvHD treatment in 381 | ST2 levels measured at the initiation of therapy for GVHD and during the first month after transplantation improved risk stratification for treatment-resistant GVHD and death without relapse after transplantation |
| Ponce et al. (18) | Predictive | Day 28 samples from 113 cord blood transplant patients | ST2 was the only biomarker associated with grades II-IV and III-IV aGVHD and transplant related mortality | |
| McDonald et al. (19) | Predictive | 149 GvHD patients across 2 cohorts, 167 GvHD-free patients | ST2 was found to be useful in predicting more severe GvHD and non-relapse mortality. | |
| Reg3α | Zhao et al. (22) | Diagnostic | 28 allogeneic transplant patients who developed GI GvHD symptoms | Reg3α serum levels rose in systematic circulation as GVHD progressively destroyed Paneth cells and reduced GI epithelial barrier function |
| Cai et al. (23) | Diagnostic/ Prognostic of GI aGvHD |
103 allo-HSCT patients, serum collected before and after transplantation and following GvHD treatment | Increased plasma Reg3α level after transplantation suggests the incidence of grades III-IV GI-aGVHD. The high level of plasma Reg3α in patients with grades III-IV GI-aGVHD after the immunosuppressive treatment for 4 weeks indicates a poor prognosis. | |
| Shin et al. (27) | Predictive | Discovery set of 5 aGVHD patients and 5 controls, compared to an independent validation set of 89 patients | Plasma-derived protein biomarkers including Reg3α can be used to predict aGVHD and NRM before the onset of clinical manifestations. | |
| TIM3 | Abu Zaid et al. (28) | Predictive | Multicenter study with uniform GVHD prophylaxis, conditioning regimen, and donor source, explored correlation biomarkers with outcomes in 211 patients | High plasma TIM3 at day 28 correlated with 2-year non-relapse mortality in multivariate analysis and overall survival |
| McDonald et al. (29) | Predictive | 165 patients after 14 days of glucocorticoid therapy to evaluate associations with treatment failure and non-relapse mortality | Clinical findings (serum bilirubin, skin GVHD) and plasma biomarkers (TIM3, ST2, sTNFR1) can predict failure of GVHD treatment and NRM. However, inadequate positive predictive values for identifying high-risk GVHD cohorts | |
| sTNFR1IL-6 | McDonald et al. (19) | Predictive | 149 GvHD patients across 2 cohorts, 167 GvHD-free patients | Levels of IL6 and sTNFR1 had utility in predicting development of grade 3–4 GVHD. sTNFR1 predicted non-relapse mortality within 1 year after transplantation |