Serum follistatin level as a prognostic marker in Haploidentical stem cell transplantation

• Published in: Transplant immunology 2022-04, Vol.71, p.101542-101542, Article 101542
• Main Authors: Azzazi, Mohamed O., El Salakawy, Walaa A., Mohamed, Haydi S.
• Format: Article
• Language: English
• Subjects: Follistatin; Graft vs Host Disease; GVHD; Haploidentical; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Prognosis; Transplantation Conditioning; Transplantation, Haploidentical
• ISSN: 0966-3274; 1878-5492
• DOI: 10.1016/j.trim.2022.101542

The treatment of hematological diseases with Haploidentical transplantation has made significant progress. Follistatin is an angiogenic factor that is elevated in the circulation after allogeneic Hematopoietic Cell Transplantation (HCT). Elevated follistatin levels have been linked to poor survival after graft versus host disease (GVHD). Pre- and post-transplant Follistatin levels were measured in patients subjected to Haploidentical HSCT and correlated with transplant outcomes. This study included 45 patients who underwent allogeneic stem cell transplants from Haploidentical donors. The mean Follistatin level before stem cells infusion (88.81 ± 49.11 ng/ml) and at day 28 post-transplant (78.61 ± 45.50 ng/ml). The mean follistatin level was higher among the patients who had acute severe GVHD grade 3–4 pre-transplant at day zero and day 28 without statistical significance. The incidence of veno-occlusive disease was higher in patients with elevated serum follistatin levels on day 0 (108.58 ± 64.12 Vs 82.16 ± 46.05 ng/ml. p value = 0.134) and day 28 (112 ± 49.36 vs 66.06 ± 38.96 ng/ml) with statistically significance at day 28 post-transplant (p value = 0.011). After 180 days of follow-up, patients with high serum follistatin (i.e. >60 ng/ml) on day 28 post-transplant had lower OS, (P = 0.381). In the setting of Haploidentical HSCT, higher follistatin levels post-transplant are associated with severe acute GVHD and inferior overall survival. •Haplo-identical transplantation treatment of hematological diseases has made great advances. Graft-versus-host disease (GVHD) continues to compromise the overall success of allogeneic hematopoietic cell transplantation (HCT).Many studies have sought to identify biomarkers that are predictive of outcomes following allogeneic HCT.•Follistatin is an angiogenic factor elevated in the circulation after allogeneic HCT. Elevations in follistatin level associated with poor survival after (GVHD) and associated with increase the occurance of veno-occlusive disease