Follistatin Level as a Prognostic Marker of Allogenic HSCT in Haematological Disease

Abstract

raft-versus-host disease (GVHD) continues to compromise the overall success of allogeneic hematopoietic cell transplantation (HCT). Although rates and severity of acute GVHD have decreased with improvements in donor selection criteria, pharmacologic prophylaxes, and supportive care, rates of chronic GVHD have remained remarkably stable at 35% to 50% for many years. Follistatin is an angiogenic factor elevated in the circulation after allogeneic hematopoietic cell transplantation (HCT). Elevations in follistatin plasma concentrations are associated with the onset of and poor survival after acute graft versus host disease (aGVHD) We have identified an association between baseline recipient circulating plasma follistatin levels with the subsequent development of aGVHD, and we have further shown that day 28 follistatin is increased among individuals experiencing early aGVHD and mortality after allogeneic HCT. This study demonstrates its utility as a prospective biomarker for aGVHD risk. Our findings are complementary to previous work examining biomarkers in GVHD and support the use of biomarkers to predict onset and treatment response of certain post-HCT complications.