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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 observa...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779849/ https://www.ncbi.nlm.nih.gov/pubmed/31632401 http://dx.doi.org/10.3389/fimmu.2019.02319 |
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author | Greco, Raffaella Lorentino, Francesca Nitti, Rosamaria Lupo Stanghellini, Maria Teresa Giglio, Fabio Clerici, Daniela Xue, Elisabetta Lazzari, Lorenzo Piemontese, Simona Mastaglio, Sara Assanelli, Andrea Marktel, Sarah Corti, Consuelo Bernardi, Massimo Ciceri, Fabio Peccatori, Jacopo |
author_facet | Greco, Raffaella Lorentino, Francesca Nitti, Rosamaria Lupo Stanghellini, Maria Teresa Giglio, Fabio Clerici, Daniela Xue, Elisabetta Lazzari, Lorenzo Piemontese, Simona Mastaglio, Sara Assanelli, Andrea Marktel, Sarah Corti, Consuelo Bernardi, Massimo Ciceri, Fabio Peccatori, Jacopo |
author_sort | Greco, Raffaella |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-6779849 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-67798492019-10-18 Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide Greco, Raffaella Lorentino, Francesca Nitti, Rosamaria Lupo Stanghellini, Maria Teresa Giglio, Fabio Clerici, Daniela Xue, Elisabetta Lazzari, Lorenzo Piemontese, Simona Mastaglio, Sara Assanelli, Andrea Marktel, Sarah Corti, Consuelo Bernardi, Massimo Ciceri, Fabio Peccatori, Jacopo Front Immunol Immunology 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. Frontiers Media S.A. 2019-10-01 /pmc/articles/PMC6779849/ /pubmed/31632401 http://dx.doi.org/10.3389/fimmu.2019.02319 Text en Copyright © 2019 Greco, Lorentino, Nitti, Lupo Stanghellini, Giglio, Clerici, Xue, Lazzari, Piemontese, Mastaglio, Assanelli, Marktel, Corti, Bernardi, Ciceri and Peccatori. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Greco, Raffaella Lorentino, Francesca Nitti, Rosamaria Lupo Stanghellini, Maria Teresa Giglio, Fabio Clerici, Daniela Xue, Elisabetta Lazzari, Lorenzo Piemontese, Simona Mastaglio, Sara Assanelli, Andrea Marktel, Sarah Corti, Consuelo Bernardi, Massimo Ciceri, Fabio Peccatori, Jacopo Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide |
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 | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779849/ https://www.ncbi.nlm.nih.gov/pubmed/31632401 http://dx.doi.org/10.3389/fimmu.2019.02319 |
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