Early Biomarker Algorithm May Predict Graft-vs-Host Disease Occurrence

Key Points

  • Two proteins present in blood—ST2 and REG3a—drawn a week after a transplant can predict whether a patient will develop a lethal version of graft-vs-host disease weeks before the disease's symptoms normally occur.
  • Researchers are now designing clinical trials to determine whether immunotherapy drugs, normally used during the onset of graft-vs-host disease, would benefit patients as soon as this new blood test determined they would be at high risk for severe onset of the disease.

Researchers at Mount Sinai Health System have discovered a way to predict whether patients with blood cancer who received a bone marrow transplant will develop graft-vs-host disease, according to a study published by Hartwell et al in JCI (The Journal of Clinical Investigation) Insight.

Protein Presence

The international study at 11 cancer centers examined blood samples from almost 1,300 bone marrow transplant patients, and found that two proteins present in blood drawn a week after a transplant can predict whether a patient will develop a lethal version of graft-vs-host disease weeks before the disease's symptoms normally occur. Scientists at the Mount Sinai Acute Graft-vs-Host Disease International Consortium (MAGIC) created an algorithm—dubbed the “MAGIC algorithm”—that determines a patient's risk of developing the disease by measuring concentrations of these proteins, ST2 and REG3a.

“The MAGIC algorithm gives doctors a roadmap to save many lives in the future. This simple blood test can determine which bone marrow transplant patients are at high risk for a lethal complication before it occurs,” said James L.M. Ferrara, MD, Professor of Pediatrics, Oncological Sciences, and Medicine, Hematology, and Medical Oncology at The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai, and Co-Director of MAGIC. “It will allow early intervention and potentially save many lives.”

Doctors at Mount Sinai are now designing clinical trials to determine whether immunotherapy drugs, normally used during the onset of graft-vs-host disease, would benefit patients as soon as this new blood test determined they would be at high risk for severe onset of the disease. Researchers believe that if patients receive the drugs once the test is administered—which is well before symptoms develop—they would be spared the full force of the disease, and fewer of them would die.

“This test will make bone marrow transplant safer and more effective for patients because it will guide adjustment of medications to protect against graft-vs-host disease,” said John Levine, MD, MS, Professor of Pediatrics and Medicine, Hematology, and Medical Oncology at The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai, and Co-Director of MAGIC. “If successful, the early use of the drugs would become a standard of care for bone marrow transplant patients.”

Between 40% and 60% of patients who receive bone marrow transplants later develop severe graft-vs-host disease, and about 40% of graft-vs-host disease cases are lethal.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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