A prognostic score for acute graft-versus-host disease based on biomarkers: a multicentre study

Publication date: January 2015 Source:The Lancet Haematology, Volume 2, Issue 1 Author(s): John E Levine , Thomas M Braun , Andrew C Harris , Ernst Holler , Austin Taylor , Holly Miller , John Magenau , Daniel J Weisdorf , Vincent T Ho , Javier Bolaños-Meade , Amin M Alousi , James L M Ferrara Background Graft-versus-host disease (GVHD) is the major cause of non-relapse mortality after allogeneic haemopoietic stem-cell transplantation (SCT). The severity of symptoms at the onset of GVHD does not accurately define risk, and thus most patients are treated alike with high dose systemic corticosteroids. We aimed to define clinically meaningful risk strata for patients with newly diagnosed acute GVHD using plasma biomarkers. Methods Between April 13, 2000, and May 7, 2013, we prospectively collected plasma from 492 SCT patients with newly diagnosed acute GVHD and randomly assigned (2:1) using a random number generator, conditional on the final two datasets having the same median day of onset, into training (n=328) and test (n=164) sets. We used the concentrations of three recently validated biomarkers (TNFR1, ST2, and Reg3α) to create an algorithm that computed the probability of non-relapse mortality 6 months after GVHD onset for individual patients in the training set alone. We rank ordered the probabilities and identified thresholds that created three distinct non-relapse mortality scores. We evaluated the algorithm in the test set, and again in an independe...
Source: The Lancet Haematology - Category: Hematology Source Type: research