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Low EGF in myeloablative allotransplantation: association with severe acute GvHD in BMT CTN 0402.

Abstract：

:Epidermal growth factor (EGF) is a recently described biomarker of acute GvHD (aGvHD). Whether low plasma EGF prior to hematopoietic cell transplantation (HCT) predisposes to the development of aGvHD, or whether EGF levels fall because of severe aGvHD, is unknown. To evaluate this, we tested plasma samples collected at pre-HCT baseline, day +28 and day +100 during the course of the Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 0402. We found that baseline EGF plasma concentrations were three-fold lower in HCT recipients compared to donors (24.3 vs 76.0 pg/mL, P<0.01). Ninety-one patients (43%) had a markedly low plasma EGF at pre-HCT baseline, defined as <2.7 pg/mL-an optimal cutpoint associated with development of grade III-IV aGvHD. Patients with these low EGF levels at pre-HCT baseline had a 2.9-fold increased risk of grade III-IV aGvHD by day +100. Patients with low EGF at day +28 after HCT had an increased risk of death (relative risk 2.3, P=0.02) by 1 year due to transplant-related toxicities, especially aGvHD. Our results suggest that very low plasma EGF early in the HCT process may predispose patients to an increased risk of death, potentially due to epithelial damage and limited repair capacity.

journal_name

Bone Marrow Transplant

journal_title

Bone marrow transplantation

authors

Holtan SG,Newell LF,Cutler C,Verneris MR,DeFor TE,Wu J,Howard A,MacMillan ML,Antin JH,Blazar BR,Weisdorf DJ,Panoskaltsis-Mortari A

doi

10.1038/bmt.2017.89

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

1300-1303

issue

9

eissn

0268-3369

issn

1476-5365

pii

bmt201789

journal_volume

52

pub_type

杂志文章

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