Elevated REG3α predicts refractory aGVHD in patients who received steroids-ruxolitinib as first-line therapy

作者：Yang, Jingjing; Peng, Bo; Wang, Lu; Li, Xin; Li, Fei; Jin, Xiangshu; Jia, Mingyu; Xu, Lingmin; Dou, Liping^*; Liu, Daihong^*

来源：Annals of Hematology, 2022, 101(3): 621-630.

DOI：10.1007/s00277-021-04727-1

• Acute graft-versus-host disease
• Ruxolitinib
• First-line therapy
• Biomarker

We started a single-arm, phase II, open-label, prospective clinical trial using steroids-ruxolitinib as the first-line therapy for intermediate- to high-risk aGVHD (NCT04397367). Here, we report the association of a biomarker panel (sST2, REG3 alpha, sTNFR1, IL-6 and IL-8) with responses to GVHD therapy. The novel first-line therapy for 39 patients with newly diagnosed aGVHD consisted of 1 mg/kg methylprednisolone and 5 mg/day ruxolitinib. The serum concentrations of the biomarkers were prospectively detected at planned time points. Of the 39 patients, the complete response rate at day 28 was 82.05%. In patients who achieved CR, the concentrations of REG3 alpha (P-14 = 0.01; P-28 = 0.10) and sTNFR1 (P-14 = 0.42; P-28 = 0.04) declined at day 14 and day 28 compared with the pre-enrolment levels. In refractory patients, the levels of REG3 alpha at day 14 were higher than those pre-enrolment (P = 0.04). REG3 alpha (P = 0.02) was elevated in the refractory patients compared with the patients achieving CR at day 14 after enrolment, while there was no significant difference in the levels of sST2, sTNFR1 or IL-6. Elevated REG3 alpha levels may predict refractory aGVHD after novel first-line therapy with steroids-ruxolitinib.

• 单位
  5; 1; 南方医科大学