Biomarkers for early complications post hematopoietic cell transplantation: Insights and challenges

Abstract

Hematopoietic cell transplantation is an established curative treatment option for various hematological malignant, and non-malignant diseases. However, the success of HCT is still limited by life-threatening early complications post-HCT, such as Graft Versus Host Disease (GVHD), Sinusoidal Obstruction Syndrome (SOS), and transplant-associated microangiopathy, to name a few. A decade of research in the discovery and validation of novel blood-based biomarkers aims to manage these early complications by using them for diagnosis or prognosis. Advances in this field have also led to predictive biomarkers to identify patients’ likelihood of response to therapy. Although biomarkers have been extensively evaluated for different complications, these are yet to be used in routine clinical practice. This review provides a detailed summary of various biomarkers for individual early complications post-HCT, their discovery, validation, ongoing clinical trials, and their limitations. Furthermore, this review also provides insights into the biology of biomarkers and the challenge of obtaining a universal cut-off value for biomarkers.

Cell-free RNA Liquid Biopsy to Monitor Hematopoietic Stem Cell Transplantation

“…Complications can manifest with non-specific symptoms, such as rash or elevated liver enzymes, and progress rapidly, making early prediction and diagnosis critical. The current standard of care involves a battery of diagnostic tests including invasive tissue biopsies ( 8–10 ). There is a clear need for noninvasive molecular tests to monitor HSCT recipients and predict complications before they occur.…”

Allogeneic Stem Cell Transplantation in Treatment of Refractory/Relapsed Lymphomas

“…However, a similar effect where graft acting against the recipient's cells, such as graft versus host disease, leads to an undesirable outcome. Graft versus host disease still remains a predominant cause of morbidity and mortality in patients following hematopoietic stem cell transplantation [4].…”