Circulating B-cell activating factor level predicts clinical response of chronic graft-versus-host disease to extracorporeal photopheresis.
Extracorporeal photopheresis (ECP) is an important therapeutic option in steroid-refractory chronic graft-versus-host disease (cGVHD). Few biomarkers predicting response exist. We measured serum B-cell activating factor (BAFF) in 46 cGVHD patients receiving ECP before and during treatment course. BAFF level at 1 month of ECP predicted 3- and 6-month skin disease response, with BAFF less than 4 ng/mL associated with significant skin improvement and complete resolution in 11 of 20 patients. High BAFF at 1-month ECP associated with a worsening median 6-month skin score and resolution in 1 of 10 patients. BAFF level at 3 months also predicted the likelihood of maintaining skin disease improvement at 6 months. BAFF level was not correlated directly with extracutaneous cGVHD response, although full cutaneous responders exhibited improved extracutaneous organ response rates compared with skin nonresponders (65% vs 35%). This study suggests that early BAFF measurement during ECP for cGVHD represents a potentially useful biomarker in prediction of treatment outcome.
Haematology Department, Rotherham General Hospital, Rotherham, United Kingdom. robert.whittle@rothgen.nhs.uk
Robert
R
Whittle
Peter C
PC
Taylor
D000328:Adult; D053264:B-Cell Activating Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004351:Drug Resistance; D006086:Graft vs Host Disease / Q000097:blood* / Q000276:immunology / Q000628:therapy*; D006801:Humans; D017893:Photopheresis; D012074:Remission Induction; D012720:Severity of Illness Index; D012867:Skin / Q000276:immunology; D012871:Skin Diseases / Q000209:etiology / Q000276:immunology; D013997:Time Factors
D053264:B-Cell Activating Factor; D015415:Biomarkers