Related Experiment Video
Updated: May 28, 2026
High Throughput Sequential ELISA for Validation of Biomarkers of Acute Graft-Versus-Host Disease
Published on: October 31, 2012
Clinical laboratory markers of inflammation as determinants of chronic graft-versus-host disease activity and NIH
L Grkovic1, K Baird, S M Steinberg
1Graft-versus-Host and Autoimmunity Unit, Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Insights
Chronic graft-versus-host disease (cGVHD) activity can be monitored using common inflammation markers. Lower albumin, higher C-reactive protein, and platelet counts indicate active or severe cGVHD, aiding clinical management.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Chronic graft-versus-host disease (cGVHD) is a significant complication after allogeneic hematopoietic stem cell transplantation, leading to substantial morbidity and mortality.
- Current clinical management of cGVHD lacks standardized measures for disease activity and staging.
Purpose of the Study:
- To identify and validate clinical laboratory markers of inflammation associated with cGVHD activity and severity.
- To explore correlations between serum inflammatory markers and established cGVHD activity definitions.
Main Methods:
- Cross-sectional analysis of 189 adult patients with established cGVHD enrolled in a prospective natural history study.
- Correlation of serum inflammatory markers (albumin, C-reactive protein, platelets) with disease activity (clinician's intent to alter therapy) and severity (NIH global score).
Main Results:
- Lower serum albumin, higher C-reactive protein, higher platelet counts, and a greater number of prior systemic therapies (PST) were associated with active cGVHD.
- Higher platelet counts and a higher number of PST correlated significantly with more severe cGVHD based on NIH global scoring.
Conclusions:
- Common laboratory indicators of inflammation, including albumin, C-reactive protein, and platelets, can serve as valuable markers for assessing cGVHD activity and severity.
- These markers may aid in clinical decision-making for disease management and staging in patients with cGVHD.
Abstract:
Chronic graft-versus-host disease (cGVHD) remains a major cause of non-relapse morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Currently there are no accepted measures of cGVHD activity to aid in clinical management and disease staging. We analyzed clinical markers of inflammation in the sera of patients with established cGVHD and correlated those with definitions of disease activity. In all, 189 adults with cGVHD (33% moderate and 66% severe according to National Institutes of Health (NIH) global scoring) were consecutively enrolled onto a cross-sectional prospective cGVHD natural history study. At the time of evaluation, 80% were receiving systemic immunosuppression and failed a median of four prior systemic therapies (PST) for their cGVHD. Lower albumin (P<0.0001), higher C-reactive protein (P = 0.043), higher platelets (P = 0.030) and higher number of PST (P<0.0001) were associated with active disease defined as clinician's intention to intensify or alter systemic therapy due to the lack of response. Higher platelet count (P = 0.021) and higher number of PST (P<0.0001) were associated with more severe diseased defined by NIH global score. This study identified common laboratory indicators of inflammation that can serve as markers of cGVHD activity and severity.
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