Fecal calprotectin in allogeneic stem cell transplantation for the diagnosis of acute intestinal graft versus host disease

Oreiro, Mariana Bastos; Castilla‐Llorente, Cristina; Guía, Ana López de la; Paz, Raquel de; Domselaar, Manuel Van; Nieto, José; Rodriguez, A.; Gallardo, David; Canales, Miguel

doi:10.1038/bmt.2011.241

Cited by 11 publications

(6 citation statements)

References 10 publications

(8 reference statements)

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“…There are a few recently published studies where calprotectin estimation was analysed in patients with GVHD. Bastos Oreiro et al found that calprotectin appears to be a promising non-invasive biomarker of acute GVHD 12 . The level of calprotectin also correlated with the stage of GVHD.…”

Section: Discussionmentioning

confidence: 99%

Fecal calprotectin as a biomarker of intestinal graft versus host disease after allogeneic hematopoietic stem cell transplantation

Lorenz

Marklund

Werner

et al. 2015

Sci Rep

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The diagnosis of gastrointestinal graft versus host disease (GI-GVHD) is based on clinical symptoms and histological findings. In clinical practice, it is often difficult to decide whether abdominal symptoms in an allogeneic transplant recipient are caused by GVHD or other disorders. Endoscopic biopsies are helpful in establishing the diagnosis, but endoscopy is not always possible to perform due to poor general condition of the patients. No biomarkers are routinely used to predict GVHD. The aim of fecal calprotectin and alpha-1 antitrypsin testing in our study was to find out whether determination of the concentrations of these proteins may be used as a screening method for enteric GVHD. We studied prospectively 51 patients, 8 of whom developed GI-GVHD. Our data demonstrate that elevated fecal calprotectin levels were significantly associated with presence of GI-GVHD. We found a positive association between high F-calprotectin and severe gastrointestinal GVHD. In bivariate analysis, only calprotectin but not alpha-1 antitrypsin was independently associated with GI-GVHD. Testing for fecal calprotectin after allogeneic stem cell transplantation may be a useful screening tool.

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Section: Discussionmentioning

confidence: 99%

Fecal calprotectin as a biomarker of intestinal graft versus host disease after allogeneic hematopoietic stem cell transplantation

Lorenz

Marklund

Werner

et al. 2015

Sci Rep

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“…In one of the cohorts (n=21), median fecal calprotectin (mFC) levels were 198.9 mg/kg (range(r) =58.4-500) in patients with GVHD versus 32.2 mg/kg (r=15.6-89) in patients without GVHD (p=0.0005) [6]. In a similar cohort (n=23), mFC levels were 504 mg/kg in patients with GVHD and 107.4 mg/kg in patients without GVHD (p=<0.001) [7]. Five cohorts compared the mFC level in GI-GVHD vs. non GI-GVHD patients and the results were as follows: 318 mg/kg (r=36-596) vs. 38 mg/kg (r=35.5-56), p=0.003 (61 patients)[2]; 595 mg/kg vs. 51.7 mg/kg, p=<0.001 (64 patients)[4]; 396.6 mg/kg (r=142.1-500) vs. 115.2 mg/kg (r=58.4-292.3), p=0.02 (14 patients) [6]; 500 mg/kg vs. 95 mg/kg, p=0.0229 [9]; 56 mg/kg vs. 121 mg/kg, p=0.67 (31 patients) [10].…”

Section: Reviewmentioning

confidence: 99%

“…Abdominal symptoms, particularly diarrhea, frequently occur after allogeneic HSCT. The main causes of diarrhea include drug-induced side effects, mucosal damage due to conditioning therapy, infection by cytomegalovirus (CMV), Epstein Barr virus (EBV), various fungi, and graft vs. host disease (GVHD) [3-4,7]. Among these, GVHD is the most important complication after allogeneic HSCT and is defined as a complex immune response by donor T cells due to the recognition of minor genetic disparities in the recipient [2].…”

Section: Reviewmentioning

confidence: 99%

“…Virtually no biomarkers are available to predict responses to treatment, though 30% to 50% of patients will not respond to corticosteroids [1]. Recently, fecal calprotectin has been gaining importance and it has been suggested that fecal calprotectin levels, although not very specific, may play an important role as a screening tool as well as in predicting severity and response to corticosteroids in GI-GVHD [1-3,7]. Some researchers have also commented on the possibility of detecting GVHD with fecal calprotectin even before the emergence of clinical manifestations, however, significant data are lacking [8].…”

Section: Reviewmentioning

confidence: 99%

“…Fecal calprotectin has an established role as a diagnostic modality and a biomarker of disease activity in patients with inflammatory bowel disease (IBD), with sensitivity and specificity ranging from 80%-90% [1-2,6]. It has been suggested that fecal calprotectin may also play an important role in diagnosing and assessing the severity of GVHD and in determining response and resistance to corticosteroid treatment [1-3,7]. It might also be possible to develop an approach for detecting acute GVHD before the onset of clinical manifestations [8].…”

Section: Introductionmentioning

confidence: 99%

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Fecal Calprotectin as a Diagnostic and Prognostic Biomarker for Gastrointestinal Graft Versus Host Disease: A Systematic Review of Literature

Malik

Rafae

Durer

et al. 2019

Cureus

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The current practice for diagnosing graft versus host disease (GVHD) includes clinical or endoscopic evaluation of the patient. Clinical diagnosis is limited by an overlapping symptomatic spectrum with infectious causes, a common scenario in the post-transplant setting where an invasive procedure, such as endoscopy, is often impractical. We, therefore, evaluated the role of fecal calprotectin as a diagnostic as well as a prognostic biomarker for gastrointestinal GVHD (GI-GVHD) occurrence and severity in the post-hematopoietic transplant population. Following Prisma guidelines, we performed a systematic search of articles published after 2004 using the PubMed, Embase, Cochrane Library, and Web of Science databases. After a detailed screening, 10 studies involving a total of 494 patients were included. In the cohorts comparing median fecal calprotectin (mFC) level in GI-GVHD vs. non-GI-GVHD patients, the results indicated an increase in the mFC level in patients with GI-GVHD when compared to non-GI-GVHD patients. Similarly, an increase in the mFC level was seen in accordance with the severity of the disease. Moreover, corticosteroid-resistant patients had a higher mFC level as compared to corticosteroid-sensitive patients. Our study indicates that the mFC level can be used for diagnosing as well as predicting the treatment response to GI-GVHD. However, future randomized prospective trials involving larger populations are needed to further explore its significance.

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Fecal but not serum calprotectin is a potential marker of GVHD after stem cell transplantation

et al. 2017

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Gastrointestinal graft-versus-host disease (GvHD) represents a life-threatening complication after stem cell transplantation. Differential diagnosis between gut GvHD and other causes of diarrhea after HSCT is still subjected to endoscopy and histological findings. The research for a reliable biomarker for gut GvHD might allow an early diagnosis of this condition and a consequent prompt treatment that could reduce unfavorable outcomes. Recently, fecal calprotectin was reported as reliable marker of gut involvement. We would evaluate if serum instead of fecal calprotectin could be considered a possible biomarker of gut GvHD. Serum calprotectin was measured in a cohort of 54 patients submitted to allogeneic stem cell transplantation using ELISA assay. For a subset of 21 patients, calprotectin serum levels were compared with fecal calprotectin detection. Contrary to fecal calprotectin, we found only a trend to high level of serum calprotectin for GvHD development and gut involvement, but statistical difference was not reached. Fecal but not serum calprotectin could be considered as possible biomarker for gut GvHD.

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Fecal calprotectin in allogeneic stem cell transplantation for the diagnosis of acute intestinal graft versus host disease

Cited by 11 publications

References 10 publications

Fecal calprotectin as a biomarker of intestinal graft versus host disease after allogeneic hematopoietic stem cell transplantation

Fecal calprotectin as a biomarker of intestinal graft versus host disease after allogeneic hematopoietic stem cell transplantation

Fecal Calprotectin as a Diagnostic and Prognostic Biomarker for Gastrointestinal Graft Versus Host Disease: A Systematic Review of Literature

Fecal but not serum calprotectin is a potential marker of GVHD after stem cell transplantation

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