Von Willebrand factor and factor VIII as potential biomarkers in cGvHD

Results from a prospective longitudinal study evaluating von Willebrand factor (VWF) and factor VIII (FVIII) as potential biomarkers for diagnosis and disease monitoring in patients with chronic graft-versus-host disease (cGvHD; n = 83) were published in Bone Marrow Transplantation by Lelas et al. Patients without cGvHD who had undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT; n = 39) served as controls.

Key data: Median levels of VWF antigen (VWF:Ag; 268.2% vs 191.9%; p = 0.003), VWF activity (VWF:Ac; 261.8% vs 178.2%; p = 0.003), and FVIII (2.17 kIU/L vs 1.82 kIU/L; p = 0.006) were significantly elevated in patients with cGvHD vs controls, with the highest levels observed in active disease. Higher VWF:Ag and VWF:Ac levels were associated with liver and oral cGvHD. Significant predictors of higher VWF:Ag and VWF:Ac levels, respectively, included older age (p = 0.021 and p = 0.001), greater number of affected organs (p = 0.030 and p = 0.001), higher lactate dehydrogenase (LDH; p = 0.006 and p = 0.002), and lower albumin (p = 0.001 and p < 0.001). Predictors of elevated FVIII included older age (p = 0.015), more intensive systemic immunosuppressive therapy (p = 0.004), and higher white blood cell count (p = 0.018).

Key learning: VWF and FVIII show potential as clinically informative, readily measurable biomarkers for the diagnosis and monitoring of cGvHD activity, though additional validation in independent cohorts is required.