title: B-Cell-Based and Soluble Biomarkers in Body Liquids for Predicting Acute/Chronic Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation.
abstract: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the main curative therapy for hematological malignancy such as leukemias, lymphomas, or multiple myelomas and some other hematological disorders. In this therapy, cure of hematological diseases relies on graft-versus-malignancy effects by allogenic immune cells. However, severe posttransplant treatment-associated complications such as acute graft-versus-host disease (aGvHD) and chronic graft-versus-host disease (cGvHD) limit this approach. Most research into GvHD has concentrated on the aGvHD, while the more complex and multifaceted chronic form has been largely poorly investigated. cGvHD is a multi-organ autoimmune disorder and is the major cause of non-relapse morbidity and mortality following allo-HSCT, occurring in about 50% of patients, or 13,000-15,000 patients per year worldwide. Therefore, there is a high medical need for an early prediction of these therapy-associated toxicities. Biomarkers have gained importance over the last decade in diagnosis, in prognosis, and in prediction of pending diseases or side effects. Biomarkers can be cells, factors isolated from target tissues, or soluble factors that can be detected in body fluids. In this review, we aim to summarize some of the recent developments of biomarkers in the field of allo-HSCT. We will focus on cell-based biomarkers (B-cell subsets) for cGvHD and soluble factors including microRNA (miRNA), which are excreted into serum/plasma and urine. We also discuss the potential role of cytosolic and extracellular 70 kDa heat shock proteins (HSP70) as potential biomarkers for aGvHD and their role in preclinical models. Proteomic biomarkers in the blood have been used as predictors of treatment responses in patients with aGvHD for many years. More recently, miRNAs have been found to serve as a biomarker to diagnose aGvHD in the plasma. Another development relates to urine-based biomarkers that are usually detected by capillary electrophoresis and mass spectrometry. These biomarkers have the potential to predict the development of severe aGvHD (grades III-IV), overall mortality, and the pending development of cGvHD in patients posttransplant.
authors.affiliation: Department of Internal Medicine I, BMT, Medical University of Vienna , Vienna , Austria.
authors.forename: Mateja Kralj
authors.initials: MK
authors.lastname: Juric
authors.affiliation: Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München , Munich , Germany.
authors.forename: Maxim
authors.initials: M
authors.lastname: Shevtsov
authors.affiliation: Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München , Munich , Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Mozes
authors.affiliation: Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Transplantation Biology, Hannover Medical School , Hannover , Germany.
authors.forename: Justyna
authors.initials: J
authors.lastname: Ogonek
authors.affiliation: Hematological Sciences, Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Crossland
authors.affiliation: Hematological Sciences, Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Dickinson
authors.affiliation: Division of Hematology, Medical University of Graz , Graz , Austria.
authors.forename: Hildegard T
authors.initials: HT
authors.lastname: Greinix
authors.affiliation: Department of Internal Medicine III, University Hospital of Regensburg , Regensburg , Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Holler
authors.affiliation: Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Transplantation Biology, Hannover Medical School , Hannover , Germany.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Weissinger
authors.affiliation: Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München , Munich , Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Multhoff
keywords: B-cell subsets; biomarkers; cellular; genomics; graft-versus-host disease; heat shock protein; proteomics