Transplantation proceedings · 2026
Neopterin Levels in Pediatric Allogeneic Hematopoietic Stem Cell Transplantation: A Potential Biomarker for Acute Graft-Versus-Host Disease?
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Kirkiz Kayalı Serap, Deveci Tuba Saadet, Gülbahar Özlem, Kaya Zühre, Yenicesu İdil, Koçak Ülker
Аннотация
INTRODUCTION: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for hematologic disorders. Acute graft-versus-host disease (aGVHD) remains a major cause of nonrelapse mortality. Distinguishing aGVHD from early post-transplant complications is challenging. This study evaluated serum neopterin (Np) as a potential early biomarker in pediatric patients.
METHODS: Forty-five pediatric allo-HSCT patients with available serum samples were included. Clinical, laboratory, and transplant-related parameters were retrospectively assessed. Patients were categorized by aGVHD status. Blood samples for Np measurement were collected on days 0, 7, and 28 post-transplant and stored at -80°C. Normal Np was defined as <10 nmol/L.
RESULTS: Patients (18 female, 27 male; mean age 8.97 ± 4.82 years) underwent HSCT for acute lymphoblastic leukemia (ALL) (n: 12), acute myeloblastic leukemia (AML) (n: 9), thalassemia major (TM) (n: 10), severe aplastic anemia (sAA) (n: 9), hemophagocytic lymphohistiocytosis (HLH) (n: 2), biphenotypic leukemia (BL) (n: 1) and inborn errors of metabolism (IEM) (n: 2). Twenty-three developed aGVHD. No significant differences were observed between patients with and without aGVHD regarding age, sex, diagnosis, ABO incompatibility, HLA matching, stem cell source, infused CD34+ and CD3+ cells, myeloid and platelet engraftment, or Np levels on days 0, 7, and 28. In all patients, levels were higher on day 28 than on day 7.
CONCLUSIONS: Early detection and treatment of aGVHD after HSCT is crucial for reducing morbidity and mortality. Although no significant correlation between Np and aGVHD was observed, larger studies are warranted.
METHODS: Forty-five pediatric allo-HSCT patients with available serum samples were included. Clinical, laboratory, and transplant-related parameters were retrospectively assessed. Patients were categorized by aGVHD status. Blood samples for Np measurement were collected on days 0, 7, and 28 post-transplant and stored at -80°C. Normal Np was defined as <10 nmol/L.
RESULTS: Patients (18 female, 27 male; mean age 8.97 ± 4.82 years) underwent HSCT for acute lymphoblastic leukemia (ALL) (n: 12), acute myeloblastic leukemia (AML) (n: 9), thalassemia major (TM) (n: 10), severe aplastic anemia (sAA) (n: 9), hemophagocytic lymphohistiocytosis (HLH) (n: 2), biphenotypic leukemia (BL) (n: 1) and inborn errors of metabolism (IEM) (n: 2). Twenty-three developed aGVHD. No significant differences were observed between patients with and without aGVHD regarding age, sex, diagnosis, ABO incompatibility, HLA matching, stem cell source, infused CD34+ and CD3+ cells, myeloid and platelet engraftment, or Np levels on days 0, 7, and 28. In all patients, levels were higher on day 28 than on day 7.
CONCLUSIONS: Early detection and treatment of aGVHD after HSCT is crucial for reducing morbidity and mortality. Although no significant correlation between Np and aGVHD was observed, larger studies are warranted.