外周血半乳糖凝集素9水平对异基因造血干细胞移植急性移植物抗宿主病的预测作用

OBJECTIVE: To evaluate possible effects of Gelctin-9 on acute graft versus host disease (aGVHD) development and clinical outcomes in patients before and afer allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: Peripheral blood samples were obtained from 29 patients and 15 healthy volunteers with heparin anticoagulant tubes. Samples were analyzed using ELISA kits to measure the serum concentrations of Galectin-9. RESULTS: Patients developing aGVHD had significantly lower level of Galectin-9 [(7.96±1.18) µg/L] before allo-HSCT compared with those not developing aGVHD [(12.37±0.97) µg/L, P<0.001]. And after allo-HSCT, the consentration of Galectin-9 increased markedly in patients developing aGVHD [(17.78±1.78) µg/L] compared with those not developing aGVHD [(9.45±0.80) µg/L, P<0.001]. Patients developing 3–4 grade aGVHD had significantly higher level of Galectin-9 [(23.25±2.59) µg/L] compared with those developing 1–2 grade aGVHD [(14.37±1.45) µg/L, P=0.008] and those without aGVHD [(9.45±0.80) µg/L, P<0.001]. The patients with lower level of Galectin-9 after allo-HSCT (<13.61 µg/L) showed more favorable clinical outcomes compared with those with higher level of Galectin-9 (≥13.61 µg/L). The 3-year overall survival rates were (100.00±6.05) % and (69.23±12.80) %, respectively (P=0.009). The cumulative incidence of non-relapse mortality was significantly higher in high Galectin-9 group [(23.08±11.69) %] in comparison with low Gaelctin-9 group [(0.00±7.39) %] (P=0.023). There was no significant difference between the two groups in terms of the cumulative incidence of relapse. The cumulative incidence of relapse at 3 years were (8.33±7.98) % and (12.50±8.27) % in high and low Galectin-9 groups, respectively (P=0.708). CONCLUSIONS: The serum concentration of Galectin-9 at the time of engraftment after allo-HSCT may be used as a predictor for the development and severity of aGVHD. Galectin-9 might be considered as a potential new approach to regulate transplant rejection to achieve desirable survival.