CXCL9 Predicts Severity at the Onset of Chronic Graft-versus-host Disease
| Autor: | Thomas Luft, Carsten Müller-Tidow, Manuela Hummel, Axel Benner, Aleksandar Radujkovic, Mark-Alexander Schwarzbich, Peter Dreger, Katharina Dischinger, Nicola Giesen, Natalia Becker |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Graft vs Host Disease Disease Chemokine CXCL9 Risk Assessment Severity of Illness Index Gastroenterology Young Adult Predictive Value of Tests Risk Factors immune system diseases hemic and lymphatic diseases Internal medicine Severity of illness medicine Humans Transplantation Homologous Young adult Risk factor Aged Retrospective Studies Transplantation business.industry Hazard ratio Retrospective cohort study Middle Aged medicine.disease Treatment Outcome Graft-versus-host disease Chronic Disease Female business Biomarkers Immunosuppressive Agents Stem Cell Transplantation |
| Zdroj: | Transplantation. 104:2354-2359 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/tp.0000000000003108 |
| Popis: | BACKGROUND Chronic graft-versus-host disease (cGVHD) represents a double-edged sword. In its nonsevere form, cGVHD associates with better control of the malignant disease, thus highlighting graft-versus-leukemia effects. However, severe cGVHD leads to debilitating morbidity and increased nonrelapse mortality. The prediction of severe cGVHD, in particular at disease onset, is therefore of high importance for ensuing clinical decisions and overall success of allogeneic stem cell transplantations. CXC-chemokine ligand 9 (CXCL9) is an interferon-inducible chemokine of the CXC family and is increased in cGVHD. Endothelial activation and stress index (EASIX) was shown to predict death after acute graft-versus-host disease. We explored CXCL9 and EASIX as predictors of severe cGVHD. METHODS Sera and clinical data of 480 patients were available who survived at least 6 months following allogeneic stem cell transplantation without steroid-refractory acute graft-versus-host disease and without early relapse. CXCL9 and EASIX were measured on day +100 and onset of cGVHD. RESULTS Development of nonsevere cGVHD was significantly associated with improved overall survival (hazard ratio 0.53, P < 0.001). CXCL9 serum levels at the onset of cGVHD predicted the development of severe cGVHD later on (hazard ratio 1.33, P = 0.02). In contrast, EASIX at the onset of cGVHD was not associated with cGVHD severity but was a significant independent risk factor for overall mortality and nonrelapse mortality. CONCLUSIONS CXCL9 levels at the onset of cGVHD can help to predict severe courses of the disease and have potential for optimizing tailored administration of immunosuppressive therapy. |
| Databáze: | OpenAIRE |
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