Your browser doesn't support javascript.
loading
Prospective assessment of risk biomarkers of sinusoidal obstruction syndrome after hematopoietic cell transplantation.
Han, Yan; Bidgoli, Alan; DePriest, Brittany P; Méndez, Alejandra; Bijangi-Vishehsaraei, Khadijeh; Perez-Albuerne, Evelio D; Krance, Robert A; Renbarger, Jamie; Skiles, Jodi L; Choi, Sung W; Liu, Hao; Paczesny, Sophie.
Affiliation
  • Han Y; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA.
  • Bidgoli A; Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA.
  • DePriest BP; Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA.
  • Méndez A; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
  • Bijangi-Vishehsaraei K; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
  • Perez-Albuerne ED; Department of Pediatrics, Children's National Medical Center, Washington, DC, USA.
  • Krance RA; Department of Pediatrics, Texas Children's Hospital, and Baylor College of Medicine, Houston, Texas, USA.
  • Renbarger J; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
  • Skiles JL; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
  • Choi SW; Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.
  • Liu H; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA.
  • Paczesny S; Department of Biostatistics and Epidemiology, Rutgers School of Public Health, New Brunswick, New Jersey, USA.
JCI Insight ; 8(10)2023 05 22.
Article in En | MEDLINE | ID: mdl-37071469
BACKGROUNDCurrently, no laboratory tests exist to stratify for the risk of developing sinusoidal obstruction syndrome (SOS), an early endothelial complication after hematopoietic cell transplantation (HCT). Risk biomarkers of SOS have not been verified in a prospective cohort accounting for differences between practices across institutions. Herein, we aimed to define risk groups for SOS occurrence using 3 proteins: L-ficolin, hyaluronic acid (HA), and stimulation 2 (ST2). METHODSBetween 2017 and 2021, we prospectively accrued 80 pediatric patients across 4 US centers. Biomarkers were tested by ELISA blind to patient groupings and associated with SOS incidence on day 35 after HCT, and overall survival (OS) on day 100 after HCT. Cutpoints were identified using retrospective cohorts and applied to the prospective cohort.RESULTSCombination of the 3 biomarkers measured on day 3 after HCT in the prospective cohort provided 80% (95% CI 55%-100%) sensitivity and 73% (95% CI 62%-83%) specificity for risk of SOS occurrence. Patients with low L-ficolin were 9 times (95% CI 3-32) more likely to develop SOS, while patients with high HA and ST2 were 6.5 (95% CI 1.9-22.0) and 5.5 (95% CI 2.3-13.1) times more likely to develop SOS. These 3 markers also predicted worse day 100 OS - L-ficolin: HR, 10.0 (95% CI 2.2-45.1), P = 0.0002; HA: HR, 4.1 (95% CI 1.0-16.4), P = 0.031; and ST2: HR, 3.9 (95% CI 0.9-16.4), P = 0.04.CONCLUSIONL-ficolin, HA, and ST2 levels measured as early as 3 days after HCT improved risk stratification for SOS occurrence and OS and may guide risk-adapted preemptive therapy.TRIAL REGISTRATIONClinicalTrials.gov NCT03132337.FUNDINGNIH.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Hepatic Veno-Occlusive Disease / Hematopoietic Stem Cell Transplantation Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Child / Humans Language: En Journal: JCI Insight Year: 2023 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Hepatic Veno-Occlusive Disease / Hematopoietic Stem Cell Transplantation Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Child / Humans Language: En Journal: JCI Insight Year: 2023 Document type: Article Affiliation country: Country of publication: