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

Lorenz F, Marklund S, Werner M, Palmqvist R, Wahlin BE, Wahlin A - Sci Rep (2015)

Bottom Line: Our data demonstrate that elevated fecal calprotectin levels were significantly associated with presence of GI-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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Sciences, Umeå University, Sweden.

ABSTRACT
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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Calprotectin was significantly higher in patients with GI-GVHD than in patients without GI-GVHD (p = 0.016).Alpha-1 antitrypsin was also higher among patients with GI-GVHD (p = 0.058).
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f1: Calprotectin was significantly higher in patients with GI-GVHD than in patients without GI-GVHD (p = 0.016).Alpha-1 antitrypsin was also higher among patients with GI-GVHD (p = 0.058).

Mentions: The maximal fecal calprotectin levels where markedly higher in the eight patients who developed GI-GVHD than in those who did not (median 850 mg/kg vs 119 mg/kg; p = 0.016; Figure 1). Four out of five patients with fecal calprotectin > 800 mg/kg) developed GI-GVHD, but one did not. This patient had acute liver GVHD grade III and was simultaneously PCR positive for CMV. Two other patients with elevated calprotectin levels, 770 and 348 mg/kg, respectively, also had liver GVHD. None of the GVHD patients without liver-GVHD or GI-GVHD had calprotectin exceeding 200 mg/kg. Also, when only looking at the 25 patients who underwent endoscopy, the difference in calprotectin between the eight patients with verified GI-GVHD and the other seventeen was significant (p = 0.031).


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

Lorenz F, Marklund S, Werner M, Palmqvist R, Wahlin BE, Wahlin A - Sci Rep (2015)

Calprotectin was significantly higher in patients with GI-GVHD than in patients without GI-GVHD (p = 0.016).Alpha-1 antitrypsin was also higher among patients with GI-GVHD (p = 0.058).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300489&req=5

f1: Calprotectin was significantly higher in patients with GI-GVHD than in patients without GI-GVHD (p = 0.016).Alpha-1 antitrypsin was also higher among patients with GI-GVHD (p = 0.058).
Mentions: The maximal fecal calprotectin levels where markedly higher in the eight patients who developed GI-GVHD than in those who did not (median 850 mg/kg vs 119 mg/kg; p = 0.016; Figure 1). Four out of five patients with fecal calprotectin > 800 mg/kg) developed GI-GVHD, but one did not. This patient had acute liver GVHD grade III and was simultaneously PCR positive for CMV. Two other patients with elevated calprotectin levels, 770 and 348 mg/kg, respectively, also had liver GVHD. None of the GVHD patients without liver-GVHD or GI-GVHD had calprotectin exceeding 200 mg/kg. Also, when only looking at the 25 patients who underwent endoscopy, the difference in calprotectin between the eight patients with verified GI-GVHD and the other seventeen was significant (p = 0.031).

Bottom Line: Our data demonstrate that elevated fecal calprotectin levels were significantly associated with presence of GI-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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Sciences, Umeå University, Sweden.

ABSTRACT
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.

Show MeSH
Related in: MedlinePlus