Plasma biomarkers of lower gastrointestinal and liver acute GVHD.

Abstract	The lower gastrointestinal tract (LGI) and liver are the GVHD target organs most associated with treatment failure and nonrelapse mortality. We recently identified regenerating islet-derived 3-α (REG3α) as a plasma biomarker of LGI GVHD. We compared REG3α with 2 previously reported GI and liver GVHD diagnostic biomarkers, hepatocyte growth factor (HGF) and cytokeratin fragment 18, in 954 hematopoietic cell transplantation patients. All 3 biomarkers were significantly elevated in LGI GVHD compared with non-GVHD diarrhea; REG3α discerned LGI GVHD from non-GVHD diarrhea better than HGF and cytokeratin fragment 18. Although all 3 biomarkers predicted nonresponse to therapy at day 28 in LGI GVHD patients, only REG3α and HGF concentrations predicted 1-year nonrelapse mortality (P = .01 and P = .02, respectively). Liver GVHD without GI involvement at GVHD onset and non-GVHD liver complications were uncommon; all 3 biomarkers were elevated in liver GVHD, but did not distinguish GVHD from other causes of hyperbilirubinemia.
Authors	Andrew C Harris, James L M Ferrara, Thomas M Braun, Ernst Holler, Takanori Teshima, John E Levine, Sung W Choi, Karin Landfried, Koichi Akashi, Mark Vander Lugt, Daniel R Couriel, Pavan Reddy, Sophie Paczesny
Journal	Blood (Blood) Vol. 119 Issue 12 Pg. 2960-3 (Mar 22 2012) ISSN: 1528-0020 [Electronic] United States
PMID	22286196 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References	Antigens, Neoplasm Biomarkers Biomarkers, Tumor Keratin-18 Lectins, C-Type Pancreatitis-Associated Proteins REG3A protein, human Hepatocyte Growth Factor
Topics	Adolescent Adult Aged Antigens, Neoplasm (blood) Area Under Curve Biomarkers (blood) Biomarkers, Tumor (blood) Child Child, Preschool Enzyme-Linked Immunosorbent Assay Female Gastrointestinal Tract (pathology) Graft vs Host Disease (blood, mortality) Hematopoietic Stem Cell Transplantation (adverse effects) Hepatocyte Growth Factor (blood) Humans Infant Infant, Newborn Keratin-18 (blood) Lectins, C-Type (blood) Liver (pathology) Male Middle Aged Pancreatitis-Associated Proteins ROC Curve Young Adult

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