Elevation of early plasma biomarkers in patients with clinical risk factors predicts the increased nonrelapse mortality after allogeneic hematopoietic stem cell transplantation: Biomarkers for nonrelapse mortality

• Published in: Transplantation and cellular therapy 2021-05
• Main Authors: Hotta, Masaaki, Satake, Atsushi, Yoshimura, Hideaki, Fujita, Shinya, Katayama, Yuta, Ota, Shuichi, Hanamoto, Hitoshi, Oyake, Tatsuo, Ito, Shigeki, Okada, Masaya, Nakanishi, Takahisa, Ito, Tomoki, Ishii, Kazuyoshi, Nomura, Shosaku
• Format: Article
• Language: English
• ISSN: 2666-6367

Early prediction of nonrelapse mortality (NRM) in patients who undergo allogeneic hematopoietic stem cell transplantation (aHSCT) based on the results of laboratory tests are challenging. There is, therefore, a need for evaluation of biomarkers for prediction of nonrelapse mortality, which is a major problem that offsets the advantages of aHSCT. We tested the validity and efficacy of two plasma biomarkers (ST2 and Reg3α) based on the Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm for early prediction of NRM in Japanese patients who underwent aHSCT. We conducted a multicenter retrospective study to analyze the clinical data of 112 patients with hematopoietic malignancies who underwent aHSCT. Patient blood samples on day 7 after aHSCT were obtained from six hospitals. The plasma concentrations of ST2 and Reg3α were used to calculate the 6-month NRM risk score. Based on the scores determined in this study, we identified 64 low-risk and 48 high-risk patients for the 6-month NRM. The cumulative incidence of 6-month NRM was 29.2% in the high-risk group and 10.9% in the low-risk group (p < 0.05). The cumulative incidence of relapse mortality was similar between the high-risk and low-risk patients. The biomarker score was predictive in patients with unrelated donor, HLA-mismatch donor, disease risk index-high/very high, and hematopoietic cell transplantation comorbidity index >0. Multivariate analysis revealed that high biomarker probability was a significant predictor of NRM. The MAGIC algorithm based on blood sample taken 7 days after aHSCT can identify individuals at high risk for NRM among patients with clinical risk factors for NRM, in a Japanese cohort.