• Doris M Ponce, Patrick Hilden, Christen Mumaw, Sean M Devlin, Marissa Lubin, Sergio Giralt, Jenna D Goldberg, Alan Hanash, Katharine Hsu, Robert Jenq, Miguel-Angel Perales, Craig Sauter, Marcel R M van den Brink, James W Young, Renier Brentjens, Nancy A Kernan, Susan E Prockop, Richard J O'Reilly, Andromachi Scaradavou, Sophie Paczesny, and Juliet N Barker.
• Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY;
• Blood. 2015 Jan 1; 125 (1): 199-205.

AbstractWhile 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 day 28 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 evaluation to facilitate future therapeutic intervention to ameliorate severe aGVHD and further improve survival after CBT.© 2015 by The American Society of Hematology.

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