Biomarkers of graft versus host disease – current knowledge and hope for the future

Abstract

Despite the progress that has been made in the diagnosis and treatment of graft versus host disease (GvHD) this complication remains a major limitation of allogeneic haematopoietic stem cell transplantation (alloHSCT). The goal of searching for GvHD biomarkers is the individualization of immunosuppressive propylaxis in patients undergoing alloHSCT and personalized therapy of patients with diagnosed GvHD. The approaches for biomarker discovery may be based on the knowledge of the pathophysiology of acute and chronic GvHD, or carried out with the use of modern proteomics. This paper presents the results of prospective studies aimed at the discovery and validation of GvHD biomarkers. The predictive, diagnostic and prognostic value of the biomarkers, such as interleukin 8, tumor necrosis factor α (TNF-α), soluble TNF receptor type 1, soluble receptor for interleukin 2, hepatocyte growth factor, cytokeratin-18 fragments, regenerating islet-derived 3-α and elafin are discussed, along with the consideration on the usefulness of monitoring of immune cells subpopulations, such as regulatory T cells, NKT cells, naive B cells and memory B cells. The potential impact of biomarkers on GvHD prophylaxis and treatment is presented.