High day 28 ST2 levels predict for acute graft-versus-host disease and transplant-related mortality after cord blood transplantation Journal Article


Authors: Ponce, D. M.; Hilden, P.; Mumaw, C.; Devlin, S. M.; Lubin, M.; Giralt, S.; Goldberg, J. D.; Hanash, A.; Hsu, K.; Jenq, R.; Perales, M. A.; Sauter, C.; van den Brink, M. R. M.; Young, J. W.; Brentjens, R.; Kernan, N. A.; Prockop, S. E.; O'Reilly, R. J.; Scaradavou, A.; Paczesny, S.; Barker, J. N.
Article Title: High day 28 ST2 levels predict for acute graft-versus-host disease and transplant-related mortality after cord blood transplantation
Abstract: While cord blood transplantation (CBT) is an effective therapy for hematologic malignancies, acute graft-versus-host disease (aGVHD) is a leading cause of transplant-related mortality (TRM). We investigated if biomarkers could predict aGVHD and TRM after day28 in CBT recipients. Day 28 samples from 113 CBT patients were analyzed. Suppressor of tumorigenicity 2 (ST2) was the only biomarker associated with grades II-IV and III-IV aGVHD and TRM. Day 180 grade III-IV aGVHD in patients with high ST2 levels was 30% (95% confidence interval [CI], 18-43) vs 13% (95% CI, 5-23) in patients with low levels (P=.024). The adverse effect of elevated ST2 was independent of HLA match. Moreover, high day 28 ST2 levels were associated with increased TRM with day 180 estimates of 23%(95% CI, 13-35) vs 5% (95% CI, 1-13) if levels were low (P = .001). GVHD was the most common cause of death in high ST2 patients. High concentrations of tumor necrosis factor receptor-1, interleukin-8, and regenerating islet-derived protein 3-α were also associated with TRM. Our results are consistent with those of adult donor allografts and warrant further prospective evaluationt of acilitate future therapeutic intervention to ameliorate severe aGVHD and further improve survival after CBT.
Keywords: adolescent; adult; child; aged; unclassified drug; major clinical study; postoperative period; outcome assessment; protein blood level; interleukin 8; tumor necrosis factor receptor 1; protein; cohort analysis; scatter factor; cause of death; acute graft versus host disease; cord blood stem cell transplantation; myeloablative conditioning; nonmyeloablative conditioning; reduced intensity conditioning; surgical mortality; cyclosporin a; mycophenolic acid 2 morpholinoethyl ester; granulocyte colony stimulating factor; serology; interleukin 2 receptor alpha; hla system; budesonide; elafin; human; male; female; article; regenerating islet derived protein 3 a; suppressor of tumorigenicity 2 protein; transplant related mortality
Journal Title: Blood
Volume: 125
Issue: 1
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2015-01-01
Start Page: 199
End Page: 205
Language: English
DOI: 10.1182/blood-2014-06-584789
PROVIDER: scopus
PMCID: PMC4281828
PUBMED: 25377785
DOI/URL:
Notes: Export Date: 2 February 2015 -- Source: Scopus
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MSK Authors
  1. Nancy Kernan
    360 Kernan
  2. Susan E Prockop
    159 Prockop
  3. Renier J Brentjens
    185 Brentjens
  4. Sergio Andres Giralt
    498 Giralt
  5. Craig Steven Sauter
    150 Sauter
  6. Alan M Hanash
    79 Hanash
  7. Doris Ponce
    126 Ponce
  8. Miguel-Angel Perales
    353 Perales
  9. Katharine C Hsu
    131 Hsu
  10. Juliet N Barker
    219 Barker
  11. Robert R Jenq
    99 Jenq
  12. James W Young
    237 Young
  13. Richard O'Reilly
    443 O'Reilly
  14. Marissa N Lubin
    77 Lubin
  15. Sean McCarthy Devlin
    277 Devlin
  16. Patrick Dale Hilden
    78 Hilden