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Published on: October 31, 2012
Serum Syndecan-1: a potent prognostic biomarker for transplant outcomes
Takayuki Yokokawa1, Masahiko Fukatsu1, Koichiro Fukuchi1
1Department of Hematology, Fukushima Medical University, Fukushima, Japan.
Introduction:
Post-transplant-associated complications arising from endothelial injury, such as sinusoidal obstruction syndrome (SOS) and transplant-associated thrombotic microangiopathy (TA-TMA), are associated with high mortality rates following hematopoietic stem cell transplantation (HSCT). Syndecan-1 (SDC1), a cell-surface proteoglycan released into the circulation upon endothelial damage, is a potential biomarker for vascular integrity. We previously demonstrated that elevated serum SDC1 levels were associated with disease severity and poor prognosis in patients with COVID-19.
Methods:
This prospective study investigated whether longitudinal serum SDC1 kinetics could predict early mortality in HSCT recipients; serial blood samples were collected from 130 patients undergoing hematopoietic stem cell transplantation (HSCT), from the day of HSCT through day 28 post-transplant, to investigate whether serum SDC1 levels could serve as a predictive marker for early mortality within 100 days after HSCT.
Results:
During the observation period, 12 patients died, of whom 9 deaths were attributed to conditions associated with endothelial injury, including SOS (n = 2), TA-TMA (n = 2), and idiopathic pneumonia syndrome (n = 3). Notably, serum SDC1 levels at Days 0, 14, and 21 after HSCT were significantly higher in patients who died within 100 days than in those who survived beyond Day 100.
Conclusion:
These findings suggest that serum SDC1 has the potential to predict early post-transplant mortality and warrants further validation in larger prospective studies.