Elevation of early plasma biomarkers in patients with clinical risk factors predicts the increased nonrelapse mortality after allogeneic hematopoietic stem cell transplantation: Biomarkers for nonrelapse mortality.

ABSTRACT Background Early prediction of nonrelapse mortality (NRM) in patients who undergo allogeneic hematopoietic stem cell transplantation (aHSCT) based on the results of laboratory tests are challenging. There is, therefore, a need for evaluation of biomarkers for prediction of nonrelapse mortality, which is a major problem that offsets the advantages of aHSCT. Objectives We tested the validity and efficacy of two plasma biomarkers (ST2 and Reg3α) based on the Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm for early prediction of NRM in Japanese patients who underwent aHSCT. Study Design We conducted a multicenter retrospective study to analyze the clinical data of 112 patients with hematopoietic malignancies who underwent aHSCT. Patient blood samples on day 7 after aHSCT were obtained from six hospitals. The plasma concentrations of ST2 and Reg3α were used to calculate the 6-month NRM risk score. Results Based on the scores determined in this study, we identified 64 low-risk and 48 high-risk patients for the 6-month NRM. The cumulative incidence of 6-month NRM was 29.2% in the high-risk group and 10.9% in the low-risk group (p 0. Multivariate analysis revealed that high biomarker probability was a significant predictor of NRM. Conclusions The MAGIC algorithm based on blood sample taken 7 days after aHSCT can identify individuals at high risk for NRM among patients with clinical risk factors for NRM, in a Japanese cohort.