High day 28 ST2 levels predict for acute graft-versus-host disease and transplant-related mortality after cord blood transplantation Academic Article uri icon


MeSH Major

  • Biomarkers
  • Cord Blood Stem Cell Transplantation
  • Graft vs Host Disease
  • Hematologic Neoplasms
  • Receptors, Cell Surface


  • While cord blood transplantation (CBT) is an effective therapy for hematologic malignancies, acute graft-versus-host disease (aGVHD) is a leading cause of transplant-related mortality (TRM). We investigated if biomarkers could predict aGVHD and TRM after day 28 in CBT recipients. Day 28 samples from 113 CBT patients were analyzed. Suppressor of tumorigenicity 2 (ST2) was the only biomarker associated with grades II-IV and III-IV aGVHD and TRM. Day 180 grade III-IV aGVHD in patients with high ST2 levels was 30% (95% confidence interval [CI], 18-43) vs 13% (95% CI, 5-23) in patients with low levels (P = .024). The adverse effect of elevated ST2 was independent of HLA match. Moreover, high day 28 ST2 levels were associated with increased TRM with day 180 estimates of 23% (95% CI, 13-35) vs 5% (95% CI, 1-13) if levels were low (P = .001). GVHD was the most common cause of death in high ST2 patients. High concentrations of tumor necrosis factor receptor-1, interleukin-8, and regenerating islet-derived protein 3-α were also associated with TRM. Our results are consistent with those of adult donor allografts and warrant further prospective evaluation to facilitate future therapeutic intervention to ameliorate severe aGVHD and further improve survival after CBT.

publication date

  • January 2015



  • Academic Article



  • eng

PubMed Central ID

  • PMC4281828

Digital Object Identifier (DOI)

  • 10.1182/blood-2014-06-584789

PubMed ID

  • 25377785

Additional Document Info

start page

  • 199

end page

  • 205


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