Biomarker profile predicts clinical efficacy of extracorporeal photopheresis in steroid-resistant acute and chronic graft-vs-host disease after allogenic hematopoietic stem cell transplant.

Abstract

We conducted a multicenter interventional study to assess the efficacy of Therakos ECP to treat steroid-resistant graft-vs-host disease (SRes-GVHD) after allogeneic HSCT and to identify biomarkers of GVHD response. A total of 62 patients were treated for acute SRes-GVHD (n = 37) or chronic SRes-GVHD (n = 25). Median time to best response was 35 days (range, 28-85) and 90 days (range, 27-240) in acute and chronic SRes-GVHD, respectively. Overall, 27 patients (72.9%) with SRes-aGVHD responded to treatment (40.5% CR and 32.4% PR). The response rate was significantly higher in grade I-II than in grade III-IV aGVHD (100% vs 50.0%, respectively, P-value = .001). In chronic SRes-GVHD, 22 patients (88%) achieved a clinical response (24.0% CR and 64% PR). Response was higher in moderate than in severe SRes-cGVHD (100% vs 75%, P = .096). In both acute and chronic SRes-GVHD patients, the percentage of peripheral blood CD3+ CD4+ was higher and CD3+ CD8+ lower in responding than nonresponding patients. Acute SRes-GVHD responding patients presented a higher number of Treg cells (CD4+ CD25+ CD127low/- ) at day 0 (P = .028) than nonresponding patients, differences that were maintained over the observation period. Phenotypic analysis of T-cell maturation showed a trend toward reduction in TCD8 naive cells, along with an increased percentage of TCD8 Mem Efect T cells after starting ECP in responding patients. None of the studied serum cytokines displayed statistically significant changes in either acute or chronic SRes-GVHD. ECP is an effective treatment for patients with SRes-GVHD. Biomarkers could help guide decision-making on ECP treatment initiation and duration.

• Authors: Paula Amat, Lucía López-Corral, Rosa Goterris, Ariadna Pérez, Olga López, Inmaculada Heras, Cristina Arbona, María Cruz Viguria, Juan Carlos Hernández-Boluda, Francisco Martínez-Ruiz, Andreu Martínez, Carlos Solano
• Journal: Journal of clinical apheresis (J Clin Apher) Vol. 36 Issue 5 Pg. 697-710 (Oct 2021) ISSN: 1098-1101 [Electronic] United States
• PMID: 34185332 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021 The Authors. Journal of Clinical Apheresis published by Wiley Periodicals LLC.

Chemical References

• Biomarkers
• Cytokines
• Steroids

Topics

• Adult
• Aged
• Biomarkers
• Cytokines (blood)
• Female
• Graft vs Host Disease (immunology, therapy)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Male
• Middle Aged
• Photopheresis (methods)
• Prospective Studies
• Steroids (therapeutic use)
• T-Lymphocytes, Regulatory (immunology)
• Transplantation, Homologous
• Treatment Outcome
• Young Adult