Pre-transplant expressions of microRNAs, comorbidities, and post-transplant mortality

We analyzed micro-RNAs (miRs) as possible diagnostic biomarkers for relevant comorbidities prior to and prognostic biomarkers for mortality following hematopoietic cell transplantation (HCT). A randomly selected group of patients (n=36) were divided into low-risk (HCT-comorbidity index [HCT-CI] score of 0 and survived HCT) and high-risk (HCT-CI scores ≥4 and deceased after HCT) groups. There were 654 miRs tested and 19 met the pre-specified significance level of p<0.1. In subsequent models, only eight miRs maintained statistical significance in regression models after adjusting for baseline demographic factors; miRs-374b and −454 were under-expressed, while miRs-142–3p, −191, −424, −590–3p, −29c, and −15b were over-expressed among high-risk patients relative to low-risk patients. Areas under the curve for these 8 miRs ranged between 0.74 to 0.81, suggesting strong predictive capacity. Consideration of miRs may improve risk-assessment of mortality and should be further explored in larger future prospective studies.