Assessment of ST2 for risk of death following graft-versus-host disease in the pediatric and adult age groups

Assessment of prognostic biomarkers of Non-Relapse Mortality (NRM) after allogeneic hematopoietic cell transplantation (HCT) in the pediatric age group is lacking. To address this need, we conducted a prospective cohort study (NCT02194439). 415 patients at six centers: 170 children 10 years, including both children and adults were accrued from 2013 to 2018. Four plasma biomarkers [stimulation-2 (ST2), interleukin-6, regenerating-islet-derived-3-alpha (REG3alpha) and tumor-necrosis-factor-receptor-1 (TNFR1)] were assessed pre-HCT and at days +7, +14, +21 post-HCT. We performed landmark analyses for NRM, dichotomizing the cohort at 26 ng/mL), TNFR1 (>3441 pg/mL), and REG3alpha (>25 ng/mL) are associated with NRM in both children 10 years [HR (CI): ST2: 2.60 (1.15-5.86), p=0.021; TNFR1: 2.09 (0.96-4.58), p=0.06; REG3alpha: 2.57 (1.19-5.55), p=0.016]. When pre-HCT biomarkers were included, only ST2 remained significant in both cohorts. After adjustment for significant covariates (race/ethnicity, malignant disease, graft, GVHD prophylaxis), ST2 remained associated with NRM only in recipients