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Treating classical Hodgkin lymphoma: Spotlight on targeted therapies
with Gilles Salles, Paul Bröckelmann, and Ann S. LaCasce
Saturday, November 2, 2024
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Acute graft-versus-host disease (GvHD) is a major complication following allogeneic hematopoietic stem cell transplant (allo-HSCT) that contributes to high non-relapse mortality (NRM). The gastrointestinal system is most commonly involved. Gastrointestinal GvHD (GI GvHD) is difficult to treat and is the greatest cause of GvHD-related mortality.1 Yet, identifying patients at risk of developing GI GvHD remains a challenge. Although some risk factors like chemotherapy and certain infections have shown to contribute, there is no widely accepted method for identifying high-risk patients. The availability of reliable pre-transplant biomarkers would help predict the risk of GI GvHD.
Shernan Holtan, University of Minnesota, Minneapolis, US, and colleagues performed a retrospective study investigating the association of pre-transplant gut barrier and inflammation biomarkers with the incidence of GI GvHD and 1-year NRM.2 Below is a summary of an abstract from the study presented during the 61st ASH annual meeting.
Table 1. GI GvHD or NMR biomarkers
Factor |
Hazard ratio |
GI GvHD biomarkers Claudin-3 AREG |
1.16 0.99 |
NRM biomarkers TIM-3 Claudin-3 Reg3a EGF |
1.59 1.38 1.04 0.99 |
Claudin-3 is a potential pre-transplant biomarker of increased risk of GI GvHD and NRM in patients undergoing allo-HSCT. The data suggest that elevated pre-transplant levels may indicate higher susceptibility to the damage caused by chemotherapy, radiotherapy, and infections, resulting in GvHD. Further studies are needed to explore whether lower intensity treatment options would minimize the risk of GvHD in those patients.
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