Annals of Hematology

, Volume 96, Issue 7, pp 1127–1133 | Cite as

Prediction of graft-versus-host disease: a biomarker panel based on lymphocytes and cytokines

  • Holger BuddeEmail author
  • Susanne Papert
  • Jens-Holger Maas
  • Holger M. Reichardt
  • Gerald Wulf
  • Justin Hasenkamp
  • Joachim Riggert
  • Tobias J. Legler
Original Article


Graft-versus-host disease (GvHD) still belongs to the major challenges after allogeneic hematopoietic stem cell transplantation (HSCT). Immune-suppressive therapy against GvHD is a double-edged sword due to risk of infections and relapse. The ability to adapt prophylactic treatment according to the probability of severe GvHD would be an essential advantage for the patients. We analyzed different biomarkers for their potential to predict the development of GvHD in 28 patients who underwent allogeneic HSCT. Blood was taken once directly after hematopoietic engraftment. In this study, patients were monitored for 12 months after HSCT for the occurrence of acute GvHD or acute/chronic GvHD overlap syndrome. Soluble IL-2 receptor and CD4/CD8 T cell ratio were independently associated with the occurrence of GvHD in the observation period. However, the largest area under the receiver operating characteristic curve with 0.90 was observed when a 5-parameter biomarker score based on CD4+ T cells, CD8+ T cells, CD19 CD21+ precursor B cells, CD4/CD8 T cell ratio, and soluble IL-2 receptor was used to predict GvHD. In addition, CD8+ T cell levels above 2.3% of all mononuclear cells after engraftment may predict relapse-free survival at least for 12 months. In summary, we found a new biomarker panel for prediction of GvHD which is featured by established laboratory assays and high statistical significance. In order to introduce the biomarker panel into routine clinical protocols, we suggest performing a larger multi-center study.


Hematopoietic stem cell transplantation Graft-versus-host disease Biomarker Relapse-free survival 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Holger Budde
    • 1
    Email author
  • Susanne Papert
    • 1
  • Jens-Holger Maas
    • 1
  • Holger M. Reichardt
    • 2
  • Gerald Wulf
    • 3
  • Justin Hasenkamp
    • 3
  • Joachim Riggert
    • 1
  • Tobias J. Legler
    • 1
  1. 1.Department of Transfusion MedicineUniversity Medical Center GöttingenGöttingenGermany
  2. 2.Institute for Cellular and Molecular ImmunologyUniversity Medical Center GöttingenGöttingenGermany
  3. 3.Department of Hematology and OncologyUniversity Medical Center GöttingenGöttingenGermany

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