FECAL calprotectin as non-invasive biomarker of acute and chronic GvHD in allogeneic stem cell transplantation

Ref ID: 18607

Author:

E. Metafuni, S. Bellesi, S. Giammarco, S. Marietti, D.G. De
Ritis, C. Fanali, M. Castagnola, C. Zuppi, G. Leone, S. Sica,
P. Chiusolo

Author address:

Catholic University S. Cuore (Rome, IT)

Full conference title:

Annual Meeting of the EBMT, 37th

Abstract:

Graft versus Host Disease (GvHD) is one of the major life
threatening complication after allogeneic stem cell transplantation (SCT). Recently, the application of proteomic tools has
allowed to identify protein pattern of biological samples in
patients (pts) with GvHD.
Several authors have investigated the role of fecal calprotectin (a neutrophil cytosolic protein) (FC) in patients affected
by infl ammatory bowel disease. So, level of fecal calprotectin seems to have a proportional correlation to the degree of
immune infl ammation of the intestinal mucosa.
The aim of our study has been to evaluate the role of FC level
as a possible non-invasive marker of GvHD.
Since February 2009 to July 2010, we enrolled 39 pts, M/F
20/19, with a median age of 49 years (range 17-65), submitted
to an allogeneic SCT in our centre. Underlying diseases were:
CLL (2 pts), ALL (5 pts), MDS (6 pts), NHL (5 pts), AML(18 pts),
HD (1pt), IMF (1pt) and plasma cell leukemia (1 pt). Twelve pts
received myeloablative conditioning and 27 received reduced
intensity conditioning. Graft was obtained from sibling donor
and MUD in 22 and 17 pts respectively. Stem cell source was
PB in 37 pts, CB in one pt and BM in another one. GvHD
prophylaxis was performed with cyclosporine A (CSA) in 3 pts,
CSA+MTX in 18 pts, CSA+MMF acid in 18 pts; six pts received
also ATG and 3 pts Campath-1H.
ELISA test for FC level was performed on day +30, +60 and +90
after SCT and at the onset of GVHD.
Pts received a median number of CD34+ 7.10×10
6
/Kg
(range 1.47-17.4). Median time to neutrophil engraftment
(PMN>0.5×10
9
/L) was 15 days (range 9-34), while a spontaneous platelet recovery (PLT>20×10
9
/L) was achieved after a
median time of 13 days (range 2-46).
TRM at 100 days was 23%: 2 pts died for aGVHD, 2 pts for
sepsis, 1 pt for pulmonary aspergillosis and 4 for progression
disease.
Seventeen pts developed aGVHD (43%) (5 pts grade I-II and
12 pts grade III-IV) and 12 pts developed cGVHD (4 pts limited
and 11 pts extensive).
FC median level in the fi rst 100 days after SCT was signifi cantly
higher in the group with aGVHD (median value 218 mg/kg vs
53 mg/kg, Fisher exact’s test p=0.0002, Fig 1) and in the group
of pts with cGVHD (median value 187.5 mg/kg vs 59 mg/kg,
Fisher exact’s test p= 0.0472). FC was also higher in extensive
than in limited cGvHD (203 mg/Kg vs 23 mg/Kg, Fisher exact’s
test p=0.0410).
Despite the small number of pts, we propose the FC level as
a marker of GVHD activity with a predictive role on cGVHD
onset.

Abstract Number: P489

Conference Year: 2011

Link to conference website: NULL

New link: NULL

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