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Updated: Oct 4, 2025
Competitive Transplants to Evaluate Hematopoietic Stem Cell Fitness
Published on: August 31, 2016
Serum follistatin level as a prognostic marker in Haploidentical stem cell transplantation
Mohamed O Azzazi1, Walaa A El Salakawy1, Haydi S Mohamed1
1Internal Medicine, Clinical Hematology and Bone Marrow Transplantation, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Background:
The treatment of hematological diseases with Haploidentical transplantation has made significant progress. Follistatin is an angiogenic factor that is elevated in the circulation after allogeneic Hematopoietic Cell Transplantation (HCT). Elevated follistatin levels have been linked to poor survival after graft versus host disease (GVHD).
Objective:
Pre- and post-transplant Follistatin levels were measured in patients subjected to Haploidentical HSCT and correlated with transplant outcomes.
Patients And Methods:
This study included 45 patients who underwent allogeneic stem cell transplants from Haploidentical donors.
Results:
The mean Follistatin level before stem cells infusion (88.81 ± 49.11 ng/ml) and at day 28 post-transplant (78.61 ± 45.50 ng/ml). The mean follistatin level was higher among the patients who had acute severe GVHD grade 3-4 pre-transplant at day zero and day 28 without statistical significance. The incidence of veno-occlusive disease was higher in patients with elevated serum follistatin levels on day 0 (108.58 ± 64.12 Vs 82.16 ± 46.05 ng/ml. p value = 0.134) and day 28 (112 ± 49.36 vs 66.06 ± 38.96 ng/ml) with statistically significance at day 28 post-transplant (p value = 0.011). After 180 days of follow-up, patients with high serum follistatin (i.e. >60 ng/ml) on day 28 post-transplant had lower OS, (P = 0.381).
Conclusion:
In the setting of Haploidentical HSCT, higher follistatin levels post-transplant are associated with severe acute GVHD and inferior overall survival.
