title: Level of vascular endothelial growth factor predicts both relapse and nonrelapse mortality after allogeneic hematopoietic stem cell transplantation.
abstract: Although the prognostic significance of vascular endothelial growth factor (VEGF) has been researched extensively in patients with hematologic malignancies undergoing chemotherapy, its role in allogeneic hematopoietic stem cell transplantation (HSCT) requires further investigation. The present study evaluated the associations between VEGF level and relapse rate and early complications after HSCT. VEGF levels were analyzed in 91 consecutive patients before the start of conditioning, on day 0, on the day of engraftment, and on the day of diagnosis of veno-occlusive disease (VOD). Compared with a normal level, an elevated high VEGF-A level before conditioning was associated with an increased 2-year relapse rate (55% versus 24%, P = .003; hazard ratio [HR], 3.25; 95% confidence interval [CI], 1.49 to 7.08) and decreased event-free survival (20% versus 44%; P = .022; HR, 2.03; 95% CI, 1.11 to 3.72). No association was found between VEGF level and the incidence of acute GVHD (P > .05). In patients with VOD, VEGF-A level was elevated on day 0 and on the day of VOD diagnosis (P < .05). A low VEGF-A level on day 0 was associated with reduced nonrelapse mortality (14% versus 35%; P = .048; HR, 0.32; 95% CI, 0.10 to 0.99). Our results indicate that a high VEGF-A level before HSCT increases the risk of relapse, and a high level after conditioning is associated with increased risks of early complications and nonrelapse mortality.
authors.affiliation: R.M. Gorbacheva Memorial Institute of Children's Hematology and Transplantation, I.P. Pavlov State Medical University, 6/8 Lev Tolstoy St, St Petersburg, Russia. Electronic address: moisiv@mail.ru.
authors.forename: Ivan S
authors.initials: IS
authors.lastname: Moiseev
authors.forename: Sergey V
authors.initials: SV
authors.lastname: Lapin
authors.forename: Elena A
authors.initials: EA
authors.lastname: Surkova
authors.forename: Margarita Y
authors.initials: MY
authors.lastname: Lerner
authors.forename: Vladimir N
authors.initials: VN
authors.lastname: Vavilov
authors.forename: Boris V
authors.initials: BV
authors.lastname: Afanasyev
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood / Q000209:etiology; D019337:Hematologic Neoplasms / Q000097:blood* / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012426:Russia / Q000453:epidemiology; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D014184:Transplantation, Homologous; D014652:Vascular Diseases / Q000097:blood / Q000209:etiology; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D055815:Young Adult
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A
keywords: Allogeneic stem cell transplantation; Vascular endothelial growth factor A; Veno-occlusive disease