ASH 2018 | Early prediction of moderate-severe chronic graft-versus-host disease

On Saturday 1 December, an oral session was held and entitled: 722. Clinical Allogeneic Transplantation: Acute and Chronic GVHD, Immune Reconstitution: GVHD Grading and Outcomes and Management at the 60th American Society of Hematology (ASH) Annual Meeting, held in San Diego, California, from 1–4 December 2018. During this session, an oral abstract was presented by Amit Kalra, University of Calgary, Calgary, AB, Canada. The title of the talk was:  Early Prediction of Moderate-Severe Chronic GvHD By Immunity Related Transcriptome.

Amit Kalra and colleagues retrospectively studied the transcriptome of immunity related genes at one month post-transplant in order to evaluate a potential early and accurate predictor of clinically significant chronic graft-versus-host disease (cGvHD).

An ideal cGvHD identifier should be able to predict cGvHD in the first month post-transplant as pre-emptive treatment is efficacious if given early before symptoms appear. An ideal cGvHD identifier should be highly sensible so every high-risk patient can be treated, it should also provide high specificity so every low-risk patient is spared from the toxicity of treatment.

Patients and methods

• N = 73 patients undergoing allogeneic transplantation
• All patients received myeloablative conditioning
• In vivo T cell depletion with ATG
• Total RNA was extracted from cryopreserved PBMNCs at one month after transplantation
• Five-hundred and seventy-nine immunity related genes plus 15 internal reference controls

Key findings

• Twelve gene GvHD transcript signature panel with high sensitivity and specificity were identified
• These transcriptome profiles significantly differ between patients who developed moderate-severe cGvHD in comparison with patients who did not have cGvHD
• Early upregulation of genes with T cell related pro-inflammatory functions were found

Amit Kalra concluded by stating that this study “provided an early prediction of moderate-severe cGvHD at one month with high sensitivity and specificity.” This method of transcriptome profiling has the potential to be used in every day clinical practice.

To listen to Amit Kalra discussing this study click here.