Inamoto Y, Martin PJ, Onstad LE, et al. Relevance of Plasma Matrix Metalloproteinase-9 for Bronchiolitis Obliterans Syndrome After Allogeneic Hematopoietic Cell Transplantation. Transplantation and Cellular Therapy. 2021; (doi: 10.1016/j.jtct.2021.06.006).

The results of a new study show that plasma matrix metalloproteinase-9 (MMP-9) could be used as a biomarker at diagnosis of new-onset bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic cell transplantation (HCT), for survival projections and prediction of treatment response. For the study, researchers tested plasma samples of 33 adult HCT patients participating in a Phase II trial of fluticasone, azithromycin and montelukast (FAM) as a treatment for new-onset BOS. They matched control samples of HCT patients who had non-BOS chronic graft-versus-host disease (GVHD) and those who never had chronic GVHD. Compared with patients with non-BOS chronic GVHD or no chronic GVHD, BOS patients had higher MMP-9 concentrations. However, MMP-3 concentrations were higher among patients with BOS or non-BOS chronic GVHD compared with those with no chronic GVHD. There was no statistical difference among YKL-40 concentrations among the three groups. Pre-FAM therapy MMP-9 concentrations were higher in patients with treatment failure within 6 months compared with those with treatment success. However, MMP-3 and YKL-40 concentrations before starting FAM therapy did not differ statistically between the groups. Overall survival was lower among patients with MMP-9 concentrations ≥ 200,000 pg/ml prior to FAM treatment compared with those with lower MMP-9 levels.

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