Dynamic changes in serum cytokine levels and their clinical significance in predicting acute GVHD

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// Chunyan Zhang 1 , Wenrong Huang 2 , Pengjun Zhang 1 , Qingyi Zhang 3 , Guanghong Guo 4 , Feng Gu 4 , Hua Yang 2 , Yurong Wang 1 , Xueliang Huang 1 , Qian Jia 1 and Yaping Tian 1 1 Core Laboratory of Translational Medicine, State Key Laboratory of Kidney Disease, Chinese People's Liberation Army General Hospital, Beijing, China 2 Department of Hematology, Chinese People's Liberation Army General Hospital, Beijing, China 3 Department of Hematology, Air Force General Hospital, People's Liberation Army, Beijing, China 4 Department of Clinical Biochemistry, Chinese People's Liberation Army General Hospital, Beijing, China Correspondence to: Yaping Tian, email: // Keywords : allogeneic hematopoietic stem cell transplantation, graft-versus-host disease, cytokines, biochemical indices, aGVHD prediction Received : October 25, 2016 Accepted : February 06, 2017 Published : February 25, 2017 Abstract To explore the clinical significance of cytokines and biochemical tests in acute graft-versus-host disease (aGVHD), we detected the concentrations of 8 cytokines and 19 conventional biochemical markers in the sera of aGVHD and non-GVHD patients throughout the process of allogeneic hematopoietic stem cell transplantation and the onset of aGVHD. Predictive models were then established using the 27 indices, and models were verified by a prospective trial. The 27 indices showed significant differences between aGVHD patients and non-GVHD control subjects (two-tailed p <0.05) prior to transplantation and before the onset of aGVHD. Our models, established by binary logistic regression on days +7 and +14, showed a significant absolute capacity of predicting grade 2~4 aGVHD with positive and negative predictive values of at least 70%. Our data showed that the progression of aGVHD could induce dynamic changes in the levels of serum cytokines and biochemical markers. Because most of these tests were less specific for aGVHD, these changes were easily neglected in clinical work. However, by combining cytokine and biochemical tests, the established prediction model can greatly improve the ability of these biomarkers to predict the development of aGVHD one or two weeks earlier.