; Hexner, Elizabeth O.
; Hogan, William J. ; Karol, Alexander B. ; Kasikis, Stelios ; Kitko, Carrie L. ; Kowalyk, Steven ; Lin, Jung-Yi ; Major-Monfried, Hannah ; Mielke, Stephan ; Merli, Pietro ; Morales, George ; Ordemann, Rainer ; Pulsipher, Michael A. ; Qayed, Muna ; Reddy, Pavan ; Reshef, Ran ; Rösler, Wolf ; Sandhu, Karamjeet S. ; Schechter, Tal ; Shah, Jay ; Sigel, Keith ; Weber, Daniela ; Wölfl, Matthias ; Wudhikarn, Kitsada ; Young, Rachel ; Levine, John E. ; Ferrara, James L. M. | Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Blood Advances | ||||
| Publisher: | AMER SOC HEMATOLOGY | ||||
| Place of Publication: | WASHINGTON | ||||
| Volume: | 3 | ||||
| Number of Issue or Book Chapter: | 23 | ||||
| Page Range: | pp. 4034-4042 | ||||
| Date: | 2019 | ||||
| Institutions: | Medicine > Zentren des Universitätsklinikums Regensburg > Transplantationszentrum | ||||
| Identification Number: |
| ||||
| Keywords: | ACUTE GVHD; END-POINT; THERAPY; RISK; SURVIVAL; SCORE; | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 47958 |
Abstract
The Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm probability (MAP), derived from 2 serum biomarkers, measures damage to crypts in the gastrointestinal tract during graft-versus-host disease (GVHD). We hypothesized that changes in MAP after treatment could validate it as a response biomarker. We prospectively collected serum samples and clinical stages of acute GVHD from 615 ...

Abstract
The Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm probability (MAP), derived from 2 serum biomarkers, measures damage to crypts in the gastrointestinal tract during graft-versus-host disease (GVHD). We hypothesized that changes in MAP after treatment could validate it as a response biomarker. We prospectively collected serum samples and clinical stages of acute GVHD from 615 patients receiving hematopoietic cell transplantation in 20 centers at initiation of first-line systemic treatment and 4 weeks later. We computed MAPs and clinical responses and compared their abilities to predict 6-month nonrelapse mortality (NRM) in the validation cohort (n = 367). After 4 weeks of treatment, MAPs predicted NRM better than the change in clinical symptoms in all patients and identified 2 groups with significantly different NRM in both clinical responders (40% vs 12%, P < .0001) and nonresponders (65% vs 25%, P < .0001). MAPs successfully reclassified patients for NRM risk within every clinical grade of acute GVHD after 4 weeks of treatment. At the beginning of treatment, patients with a low MAP that rose above the threshold of 0.290 after 4 weeks of treatment had a significant increase in NRM, whereas patients with a high MAP at onset that fell below that threshold after treatment had a striking decrease in NRM that translated into clear differences in overall survival. We conclude that a MAP measured before and after treatment of acute GVHD is a response biomarker that predicts long-term outcomes more accurately than change in clinical symptoms. MAPs have the potential to guide therapy for acute GVHD and may function as a useful end point in clinical trials.
Metadata last modified: 03 Sep 2021 09:33
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