Fecal Calprotectin: A Predictive Factor in Response to Corticosteroids in Patients with Gastrointestinal Graft-Versus-Host-Disease

Background and Aim: Acute graft-versus-host disease (aGvHD) is theprimary limitation of allogeneic hematopoietic cell transplantation, andonce it develops, there is no reliable test to monitor the responses totreatment. Calprotectin was reported to be significantly associated withthe response to treatments in gastrointestinal inflammation. In this study,we aimed to evaluate the amount of fecal calprotectin pre-transplant,before the initiation of treatment and during the course of treatment ofGvHD.Methods: In this study 25 patients (13 patients with GI-GvHD and 12patients without it) which underwent allogeneic HSCT were evaluatedin Taleghani hospital, Tehran, Iran. Gluckberg criteria were used fordiagnosis of aGvHD independently from the date of transplantation, and general symptoms were considered to approve the GI-GVHD, Then inorder to assess the FC, stool samples were taken (early or onset) andgeneral symptoms such as diarrhea, anorexia, nausea, and vomiting wereconsidered to approve the GI-GvHD. Moreover, In order to assess theFC, stool samples were taken before the transplantation and the onsetof GvHD symptoms and at intervals of 7 days to 3 weeks after startingtherapeutic approach before the transplantation and the onset of GVHDsymptoms and at intervals of 7 days to 3 weeks after starting therapeuticapproach. We monitored the fecal calprotectin in all patients.Results: Calprotectin levels decreased in both groups during follow-upfrom diagnosis to 3 weeks post-transplant. But these changes were moresevere in patients with hypersensitivity to corticosteroids.Conclusion: Our results suggest that the reduction of calprotectin levelin patients, which underwent allogeneic HSCT might have a correlationwith acute GI-GVHD incidence. Therefore, the assessment of fecalcalprotectin level before and within the treatment could be consideredas a reliable prognostic biomarker for GI-GVHD.

کلیدواژه ها:

GVHD ، Calprotectin ، Hematopoietic stem cell transplantation ، Corticosteroid ، Biomarkers