Robin M, Porcher R, Michonneau D, et al. Prospective External Validation of Biomarkers to Predict Acute Graft-Versus Host Disease Severity. Blood Advances. 2022; (doi: 10.1182/bloodadvances.2022007477).
Plasmatic biomarker panels at the onset of acute graft-versus-host-disease (GVHD) are associated with overall survival (OS) and nonrelapse mortality (NRM) following allogeneic hematopoietic stem cell transplantation, independent of clinical variables, new research shows. The prospective, non-interventional study used panels including seven biomarkers (Elafin, HGF, IL2RA, IL8, REG3, ST2, and TNFRI) to predict Day 28 (D28)-complete response to steroid, D180-OS, and D180-NRM. Biomarkers were measured at disease onset for 204 patients with acute GVHD, using previously developed algorithms. There was a significant association between initial GVHD grade and bilirubin level and all outcomes. Biomarkers yielded a modest improvement in the prediction of OS and NRM over clinical parameters. Decision curve analyses were used to evaluate the potential benefit of adding biomarker panels to clinical parameters; however, the benefits were minimal for the D28 non-response and mortality endpoints.