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World J Transplant. Aug 18, 2021; 11(8): 335-343
Published online Aug 18, 2021. doi: 10.5500/wjt.v11.i8.335
Biomarkers of graft-vs-host disease: Understanding and applications for the future
Masayuki Nagasawa
Masayuki Nagasawa, Department of Pediatrics, Musashino Red Cross Hospital, Musashino City 180-8610, Tokyo, Japan
Author contributions: Nagasawa M conceptualized the idea, reviewed the literature, and wrote the main draft of the manuscript.
Supported by partly a Grant-in-Aid for Scientific Research (KAKENHI) Grant, No. 15K09639.
Conflict-of-interest statement: I have no conflict-of-interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Masayuki Nagasawa, MD, PhD, Chief Doctor, Department of Pediatrics, Musashino Red Cross Hospital, 1-26-1, Kyonan-cho, Musashino City 180-8610, Tokyo, Japan. mnagasawa.ped@tmd.ac.jp
Received: February 16, 2021
Peer-review started: February 16, 2021
First decision: May 14, 2021
Revised: May 25, 2021
Accepted: August 10, 2021
Article in press: August 10, 2021
Published online: August 18, 2021
Abstract

Hematopoietic stem cell transplantation (HSCT) is widely performed as a treatment for malignant blood disorders, such as leukemia. To achieve good clinical outcomes in HSCT, it is necessary to minimize the unfavorable effects of acute graft-vs-host disease (GVHD) and induce the more tolerable, chronic form of the disease. For better management of GVHD, sensitive and specific biomarkers that predict the severity and prognosis of the disease have been intensively investigated using proteomics, transcriptomics, genomics, cytomics, and tandem mass spectrometry methods. Here, I will briefly review the current understanding of GVHD biomarkers and future prospects.

Keywords: Graft-vs-host disease, Hematopoietic stem cell transplantation, Biomarker, Cytokine, Graft-vs-host reaction, Organ damage

Core Tip: Graft-vs-host disease (GVHD) is the most unfavorable complication of hematopoietic stem cell transplantation (HSCT). Minimizing acute GVHD and inducing its chronic form is necessary to achieve good clinical outcomes in HSCT. GVHD consists of inflammation induced by the conditioning regimen, the alloimmune response of the T lymphocytes, and organ damage due to the graft-vs-host reaction. Biological factors have been comprehensively analyzed to identify novel combinations of biomarkers that predict acute GVHD severity and prognosis more efficiently. Currently, there are no useful biomarkers that can predict the severity and prognosis of chronic GVHD or serve a practical clinical use.