Progress in Hematology New clinical and basic aspects of graft-versus-host disease

International Journal of Hematology

, Volume 98, Issue 3, pp 275-292

Graft-versus-host disease biomarkers: omics and personalized medicine

  • Sophie PaczesnyAffiliated withDepartment of Pediatrics, Melvin and Bren Simon Cancer Center, Department of Microbiology and Immunology, Indiana University Email author 
  • , Nisha RaikerAffiliated withDepartment of Pediatrics, Melvin and Bren Simon Cancer Center, Department of Microbiology and Immunology, Indiana University
  • , Sam BrooksAffiliated withDepartment of Pediatrics, Melvin and Bren Simon Cancer Center, Department of Microbiology and Immunology, Indiana University
  • , Christy MumawAffiliated withDepartment of Pediatrics, Melvin and Bren Simon Cancer Center, Department of Microbiology and Immunology, Indiana University

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the most effective form of tumor immunotherapy available to date and the frequency of transplants continues to increase worldwide. However, while allo-HSCT usually induces a beneficial graft-versus-leukemia effect, a major source of morbidity and mortality following allo-HSCT is graft-versus-host disease (GVHD). Currently available diagnostic and staging tools frequently fail to identify those at higher risk for GVHD morbidity, treatment unresponsiveness, and death. Furthermore, there are shortcomings in the risk stratification of patients before GVHD clinical signs develop. In parallel, recent years have been characterized by an explosive evolution of omics technologies, largely due to technological advancements in chemistry, engineering, and bioinformatics. Building on these opportunities, plasma biomarkers have been identified and validated as promising diagnostic and prognostic tools for acute GVHD. This review summarizes current information on the types of GVHD biomarkers, the omics tools used to identify them, the biomarkers currently validated as acute GVHD markers, and future recommendations for incorporating biomarkers into new grading algorithms for risk-stratifying patients and creating more personalized treatment courses. Future directions will include randomized evaluations of these biomarkers in multicenter prospective studies while extending on the need for biomarkers of chronic GVHD.

Keywords

Graft-versus-host disease (GVHD) Hematopoietic stem cell transplantation (HSCT) Biomarkers Proteomics