Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide
Background: Although the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) has dramatically improved in the past decade, it is still compromised by transplant-related mortality (TRM), mainly caused by Graft-vs. -Host Disease (GvHD).Methods: We conducted a prospective observat...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-10-01
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| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fimmu.2019.02319/full |
| _version_ | 1830479421959569408 |
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| author | Raffaella Greco Francesca Lorentino Rosamaria Nitti Rosamaria Nitti Maria Teresa Lupo Stanghellini Fabio Giglio Daniela Clerici Elisabetta Xue Lorenzo Lazzari Simona Piemontese Sara Mastaglio Andrea Assanelli Sarah Marktel Consuelo Corti Massimo Bernardi Fabio Ciceri Fabio Ciceri Jacopo Peccatori |
| author_facet | Raffaella Greco Francesca Lorentino Rosamaria Nitti Rosamaria Nitti Maria Teresa Lupo Stanghellini Fabio Giglio Daniela Clerici Elisabetta Xue Lorenzo Lazzari Simona Piemontese Sara Mastaglio Andrea Assanelli Sarah Marktel Consuelo Corti Massimo Bernardi Fabio Ciceri Fabio Ciceri Jacopo Peccatori |
| author_sort | Raffaella Greco |
| collection | DOAJ |
| description | Background: Although the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) has dramatically improved in the past decade, it is still compromised by transplant-related mortality (TRM), mainly caused by Graft-vs. -Host Disease (GvHD).Methods: We conducted a prospective observational study to ascertain the potential of serum interleukin-6 (IL6) levels, measured before conditioning and 7 days after allo-HSCT, in predicting acute GvHD, TRM and survival after allo-HSCT with Post-Transplant Cyclophosphamide (PT-Cy) based GvHD prophylaxis.Results: Between April 2014 and June 2017, we collected samples from 166 consecutive allo-HSCT patients. By ROC analysis, we identified a threshold of 2.5 pg/ml for pre-transplant IL6 and 16.5 pg/ml for post-transplant IL6. Both univariate and multivariate analyses confirmed the ability of high baseline IL6 levels to predict worse OS (HR 4.3; p < 0.01) and grade II–IV acute GvHD (HR 1.8; p = 0.04), and of high post-transplant IL6 to identify patients with worse OS (HR 3.3; p < 0.01) and higher risk of grade II–IV (HR 5; p < 0.01) and grade III–IV acute GvHD (HR 10.2; p < 0.01). In multivariate analysis, both baseline (HR 6.7; p < 0.01) and post-transplant high IL6 levels (HR 3.5; p = 0.02) predicted higher TRM.Conclusions: IL6 may contribute to the risk stratification of patients at major risk for aGvHD and TRM, potentially providing a window for additional prophylactic or preemptive strategies to improve the quality of life in the early post-transplant phase and the outcome of allo-HSCT. |
| first_indexed | 2024-12-21T16:45:42Z |
| format | Article |
| id | doaj.art-42e52694a0ec4850a373f9f5116c060c |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-21T16:45:42Z |
| publishDate | 2019-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-42e52694a0ec4850a373f9f5116c060c2022-12-21T18:56:59ZengFrontiers Media S.A.Frontiers in Immunology1664-32242019-10-011010.3389/fimmu.2019.02319479386Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant CyclophosphamideRaffaella Greco0Francesca Lorentino1Rosamaria Nitti2Rosamaria Nitti3Maria Teresa Lupo Stanghellini4Fabio Giglio5Daniela Clerici6Elisabetta Xue7Lorenzo Lazzari8Simona Piemontese9Sara Mastaglio10Andrea Assanelli11Sarah Marktel12Consuelo Corti13Massimo Bernardi14Fabio Ciceri15Fabio Ciceri16Jacopo Peccatori17Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyUniversità Vita-Salute San Raffaele, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyUniversità Vita-Salute San Raffaele, Milan, ItalyHaematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyBackground: Although the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) has dramatically improved in the past decade, it is still compromised by transplant-related mortality (TRM), mainly caused by Graft-vs. -Host Disease (GvHD).Methods: We conducted a prospective observational study to ascertain the potential of serum interleukin-6 (IL6) levels, measured before conditioning and 7 days after allo-HSCT, in predicting acute GvHD, TRM and survival after allo-HSCT with Post-Transplant Cyclophosphamide (PT-Cy) based GvHD prophylaxis.Results: Between April 2014 and June 2017, we collected samples from 166 consecutive allo-HSCT patients. By ROC analysis, we identified a threshold of 2.5 pg/ml for pre-transplant IL6 and 16.5 pg/ml for post-transplant IL6. Both univariate and multivariate analyses confirmed the ability of high baseline IL6 levels to predict worse OS (HR 4.3; p < 0.01) and grade II–IV acute GvHD (HR 1.8; p = 0.04), and of high post-transplant IL6 to identify patients with worse OS (HR 3.3; p < 0.01) and higher risk of grade II–IV (HR 5; p < 0.01) and grade III–IV acute GvHD (HR 10.2; p < 0.01). In multivariate analysis, both baseline (HR 6.7; p < 0.01) and post-transplant high IL6 levels (HR 3.5; p = 0.02) predicted higher TRM.Conclusions: IL6 may contribute to the risk stratification of patients at major risk for aGvHD and TRM, potentially providing a window for additional prophylactic or preemptive strategies to improve the quality of life in the early post-transplant phase and the outcome of allo-HSCT.https://www.frontiersin.org/article/10.3389/fimmu.2019.02319/fullallogeneic hematopoietic stem cell transplantationinterleukin-6graft-vs.-host diseasetransplant-related mortalityoverall survival |
| spellingShingle | Raffaella Greco Francesca Lorentino Rosamaria Nitti Rosamaria Nitti Maria Teresa Lupo Stanghellini Fabio Giglio Daniela Clerici Elisabetta Xue Lorenzo Lazzari Simona Piemontese Sara Mastaglio Andrea Assanelli Sarah Marktel Consuelo Corti Massimo Bernardi Fabio Ciceri Fabio Ciceri Jacopo Peccatori Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide Frontiers in Immunology allogeneic hematopoietic stem cell transplantation interleukin-6 graft-vs.-host disease transplant-related mortality overall survival |
| title | Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide |
| title_full | Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide |
| title_fullStr | Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide |
| title_full_unstemmed | Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide |
| title_short | Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide |
| title_sort | interleukin 6 as biomarker for acute gvhd and survival after allogeneic transplant with post transplant cyclophosphamide |
| topic | allogeneic hematopoietic stem cell transplantation interleukin-6 graft-vs.-host disease transplant-related mortality overall survival |
| url | https://www.frontiersin.org/article/10.3389/fimmu.2019.02319/full |
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