title: The prognostic value of YKL-40 concentrations in nonmyeloablative conditioning allogeneic hematopoietic cell transplantation.
abstract: Increased plasma concentrations of YKL-40, also called chitinase-3-like-1 protein (CHI3L1), have been correlated with disease severity in a variety of malignant and inflammatory diseases. The objective of the current study was to assess pretransplant recipient and donor CHI3L1 polymorphisms and plasma YKL-40 concentrations as prognostic biomarkers in a cohort of 149 patients treated with hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning for hematologic malignancies. Recipients with pretransplant YKL-40 concentrations above the age-adjusted 95th percentile (high) had higher relapse-related mortality (33% versus 18%, P = .04; hazard ratio (HR) = 4.41, P = .01), lower progression-free survival (38% versus 64%, P < .01; HR = 2.84, P = .01), and overall survival (42% versus 69%, P = .01; HR = 3.09, P = .01). Recipients transplanted with donors with high YKL-40 concentrations had an increased probability and risk of grade 2-4 acute graft-versus-host disease (aGVHD) (93% versus 62%, P < .01; HR = 2.25, P = .02). CHI3L1 polymorphisms were associated with plasma YKL-40 concentrations, but not with clinical outcomes. In conclusion, our study suggests that plasma YKL-40 could function as a biomarker for relapse risk and treatment-related toxicity, and possibly as a tool complementing clinical risk scores such as the HCT comorbidity index.
authors.affiliation: Laboratory of Molecular Medicine, Department of Clinical Immunology-7631, University of Copenhagen, Denmark.
authors.forename: Anne Mette
authors.initials: AM
authors.lastname: Mørup
authors.forename: Brian
authors.initials: B
authors.lastname: Kornblit
authors.forename: Julia S
authors.initials: JS
authors.lastname: Johansen
authors.forename: Tania Nicole
authors.initials: TN
authors.lastname: Masmas
authors.forename: Hans O
authors.initials: HO
authors.lastname: Madsen
authors.forename: Lars
authors.initials: L
authors.lastname: Vindeløv
authors.forename: Peter
authors.initials: P
authors.lastname: Garred
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D006133:Growth Substances / Q000097:blood; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000401:mortality*; D006801:Humans; D037102:Lectins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012720:Severity of Illness Index; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006133:Growth Substances; D037102:Lectins