Disease risk and GVHD biomarkers can stratify patients for risk of relapse and nonrelapse mortality post hematopoietic cell transplant

Mina D., Aziz, Icahn Sch Med Mt Sinai; Jay, Shah, Icahn Sch Med Mt Sinai; Urvi, Kapoor, Icahn Sch Med Mt Sinai; Christina, Dimopoulos, Icahn Sch Med Mt Sinai; Sarah, Anand, University of Michigan; Allan, Augustine, Icahn Sch Med Mt Sinai; Francis, Ayuk, Univ Med Ctr Hamburg Eppendorf; Mohammed, Chaudhry, Icahn Sch Med Mt Sinai; Yi-Bin, Chen, Massachusetts General Hospital; Hannah K., Choe, Ohio State University; Aaron, Etra, Icahn Sch Med Mt Sinai; Stephanie, Gergoudis, Icahn Sch Med Mt Sinai; Matthew J., Hartwell, Icahn Sch Med Mt Sinai; Elizabeth O., Hexner, University of Pennsylvania; William J., Hogan, Mayo Clinic; Carrie L., Kitko, Vanderbilt University; Steven, Kowalyk, Icahn Sch Med Mt Sinai; Nicolaus, Kroeger, Univ Med Ctr Hamburg Eppendorf; Pietro, Merli, Bambino Gesu Pediat Hosp; George, Morales, Icahn Sch Med Mt Sinai; Ryotaro, Nakamura, City Hope Med Ctr; Rainer, Ordemann, Technische Universitat Dresden; Michael A., Pulsipher, Childrens Hosp Los Angeles; Muna, Qayed, Emory University; Ran, Reshef, Columbia University; Wolf, Roesler, Univ Hosp Erlangen; Tal, Schechter, University of Toronto; Elisabeth, Schreiner, University of Regensburg; Hrishikesh, Srinagesh, Icahn Sch Med Mt Sinai; Mattias, Woelfl, University of Wurzburg; Kitsada, Wudhikarn, Chulalongkorn University; Gregory, Yanik, University of Michigan; Rachel, Young, Icahn Sch Med Mt Sinai; Umut, Ozbek, Icahn Sch Med Mt Sinai; James L. M., Ferrara, Icahn Sch Med Mt Sinai; John E., Levine, Icahn Sch Med Mt Sinai

Persistent URL

https://open.library.emory.edu/purl/494vhhmhwv-emory

Last modified

06/25/2025

Type of Material

Article

Authors

Mina D. Aziz, Icahn Sch Med Mt Sinai

Jay Shah, Icahn Sch Med Mt Sinai

Urvi Kapoor, Icahn Sch Med Mt Sinai

Christina Dimopoulos, Icahn Sch Med Mt Sinai

Sarah Anand, University of Michigan

Allan Augustine, Icahn Sch Med Mt SinaiFrancis Ayuk, Univ Med Ctr Hamburg EppendorfMohammed Chaudhry, Icahn Sch Med Mt SinaiYi-Bin Chen, Massachusetts General HospitalHannah K. Choe, Ohio State UniversityAaron Etra, Icahn Sch Med Mt SinaiStephanie Gergoudis, Icahn Sch Med Mt SinaiMatthew J. Hartwell, Icahn Sch Med Mt SinaiElizabeth O. Hexner, University of PennsylvaniaWilliam J. Hogan, Mayo ClinicCarrie L. Kitko, Vanderbilt UniversitySteven Kowalyk, Icahn Sch Med Mt SinaiNicolaus Kroeger, Univ Med Ctr Hamburg EppendorfPietro Merli, Bambino Gesu Pediat HospGeorge Morales, Icahn Sch Med Mt SinaiRyotaro Nakamura, City Hope Med CtrRainer Ordemann, Technische Universitat DresdenMichael A. Pulsipher, Childrens Hosp Los AngelesMuna Qayed, Emory UniversityRan Reshef, Columbia UniversityWolf Roesler, Univ Hosp ErlangenTal Schechter, University of TorontoElisabeth Schreiner, University of RegensburgHrishikesh Srinagesh, Icahn Sch Med Mt SinaiMattias Woelfl, University of WurzburgKitsada Wudhikarn, Chulalongkorn UniversityGregory Yanik, University of MichiganRachel Young, Icahn Sch Med Mt SinaiUmut Ozbek, Icahn Sch Med Mt SinaiJames L. M. Ferrara, Icahn Sch Med Mt SinaiJohn E. Levine, Icahn Sch Med Mt Sinai

Language

English

Date

2020-02-04

Publisher

NATURE PUBLISHING GROUP

Publication Version

Author Accepted Manuscript (After Peer Review)

Copyright Statement

© 2020, The Author(s), under exclusive licence to Springer Nature Limited

Final Published Version (URL)

http://dx.doi.org/10.1038/s41375-020-0726-z

Title of Journal or Parent Work

LEUKEMIA

Volume

34

Issue

7

Start Page

1898

End Page

1906

Grant/Funding Information

Supported by grants (R21CA173459, P01CA03942, and P30CA196521) from the National Cancer Institute, an American Cancer Society Clinical Research Professorship (to Dr. Ferrara) and a Doris Duke Charitable Foundation Clinical Research Mentorship (to Dr. Aziz and Dr. Hartwell).

Supplemental Material (URL)

https://static-content.springer.com/esm/art%3A10.1038%2Fs41375-020-0726-z/MediaObjects/41375_2020_726_MOESM1_ESM.pdf

Abstract

The graft-versus-leukemia (GVL) effect after allogeneic hematopoietic cell transplant (HCT) can prevent relapse but the risk of severe graft-versus-host disease (GVHD) leads to prolonged intensive immunosuppression and possible blunting of the GVL effect. Strategies to reduce immunosuppression in order to prevent relapse have been offset by increases in severe GVHD and nonrelapse mortality (NRM). We recently validated the MAGIC algorithm probability (MAP) that predicts the risk for severe GVHD and NRM in asymptomatic patients using serum biomarkers. In this study we tested whether the MAP could identify patients whose risk for relapse is higher than their risk for severe GVHD and NRM. The multicenter study population (n = 1604) was divided into two cohorts: historical (2006–2015, n = 702) and current (2015–2017, n = 902) with similar NRM, relapse, and survival. On day 28 post-HCT, patients who had not developed GVHD (75% of the population) and who possessed a low MAP were at much higher risk for relapse (24%) than severe GVHD and NRM (16 and 9%); this difference was even more pronounced in patients with a high disease risk index (relapse 33%, NRM 9%). Such patients are good candidates to test relapse prevention strategies that might enhance GVL.

Author Notes