Disease risk and GVHD biomarkers can stratify patients for risk of relapse and nonrelapse mortality post hematopoietic cell transplant

Mina D. Aziz, Jay Shah, Urvi Kapoor, Christina Dimopoulos, Sarah Anand, Allan Augustine, Francis Ayuk, Mohammed Chaudhry, Yi Bin Chen, Hannah K. Choe, Aaron Etra, Stephanie Gergoudis, Matthew J. Hartwell, Elizabeth O. Hexner, William J. Hogan, Carrie L. Kitko, Steven Kowalyk, Nicolaus Kröger, Pietro Merli, George MoralesRyotaro Nakamura, Rainer Ordemann, Michael A. Pulsipher, Muna Qayed, Ran Reshef, Wolf Rösler, Tal Schechter, Elisabeth Schreiner, Hrishikesh Srinagesh, Matthias Wölfl, Kitsada Wudhikarn, Gregory Yanik, Rachel Young, Umut Özbek, James L.M. Ferrara, John E. Levine

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


The graft-versus-leukemia (GVL) effect after allogeneic hematopoietic cell transplant (HCT) can prevent relapse but the risk of severe graft-versus-host disease (GVHD) leads to prolonged intensive immunosuppression and possible blunting of the GVL effect. Strategies to reduce immunosuppression in order to prevent relapse have been offset by increases in severe GVHD and nonrelapse mortality (NRM). We recently validated the MAGIC algorithm probability (MAP) that predicts the risk for severe GVHD and NRM in asymptomatic patients using serum biomarkers. In this study we tested whether the MAP could identify patients whose risk for relapse is higher than their risk for severe GVHD and NRM. The multicenter study population (n = 1604) was divided into two cohorts: historical (2006–2015, n = 702) and current (2015–2017, n = 902) with similar NRM, relapse, and survival. On day 28 post-HCT, patients who had not developed GVHD (75% of the population) and who possessed a low MAP were at much higher risk for relapse (24%) than severe GVHD and NRM (16 and 9%); this difference was even more pronounced in patients with a high disease risk index (relapse 33%, NRM 9%). Such patients are good candidates to test relapse prevention strategies that might enhance GVL.

Original languageEnglish
Pages (from-to)1898-1906
Number of pages9
Issue number7
StatePublished - 1 Jul 2020


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