The value of monitoring the expression level of soluble tumor suppressor factor 2 in predicting early severe acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation in children
Objective:To investigate the clinical value of monitoring the expression level of soluble tumor sup-pressor factor 2(sST2)in peripheral blood after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children from different donors in predicting the occurrence of early severe acute graft-versus-host disease(aGVHD).Methods:The clinical data of 44 children who underwent allo-HSCT in our hospital from January 2020 to May 2022 were retrospectively analyzed.Eighteen children with grade Ⅲ-Ⅳ aGVHD after transplantation were selected as the observation group,and the remaining 26 children were selected as the control group.The baseline data and sST2 expression levels before allo-HSCT,14 d and 21 d after allo-HSCT were compared between the two groups.The receiver operating characteristic curve was constructed.According to the median level of sST2 ex-pression,the children were divided into a high sST2 expression group and a low sST2 expression group,and the cumulative incidence of aGVHD in different organs was compared between the two groups.Results:There was no significant difference in the level of peripheral blood sST2 before transplantation and 14 days after allo-HSCT be-tween the observation group and the control group.The level of peripheral blood sST2 in the observation group was significantly higher than that in the control group 21 days after transplantation(P＜0.001).The area under the receiver operating characteristic curve of sST2 for the diagnosis of grade Ⅲ-Ⅳ aGVHD at 21 days after allo-HSCT was 0.842(95％CI 0.715-0.968),and the corresponding sensitivity was 96％,the specificity was 67％.The children were divided into high sST2 group(22 cases)and low sST2 group(22 cases)according to the median level of sST2(71 222.0 μg/mL)in peripheral blood on day 21 after transplantation.The incidence of grade Ⅲ-Ⅳ aGVHD,grade 2-4 intestinal aGVHD,and skin aGVHD in the high sST2 group was significantly higher than that in the low sST2 group(63.6％vs 18.2％,P=0.002;59.1％vs 13.6％,P=0.002;90.9％vs 63.6％,P=0.031).The incidence of upper gastrointestinal or hepatic aGVHD also tended to be higher than that in the low sST2 group,while there was no significant difference(40.9％vs 18.2％,P=0.099).Conclusion:The elevated expression of sST2 in peripheral blood of children with hematological diseases at 21 days after allo-HSCT from different donors is helpful to predict the occurrence of Ⅲ-Ⅳ aGVHD.Peripheral blood sST2 is expected to be a biomarker for severe aGVHD after allo-HSCT,which still needs to be further confirmed by multi-center and larger sample studies.
NETL
NSTL
万方数据
