The Evaluation of Inflammatory Biomarkers in Predicting the Severity and Steroid Responsiveness of Acute Graft versus Host Disease after Haplo- Identical Transplantation

Background; Haematopoietic stem cell transplant (HSCT) is the transplant of stem cells usually derived from bone marrow, Peripheral blood, Umbilical cord, Matched sibling donor (HLA 6/6) , Or Haplo-Identical donor (HLA Matching less than 6/6but not less than 3/6) Aim and objectives; to assess the role of the EASIX formula, IL-6, CRP and Ferritin in the Severe and Steroid Responsiveness cases of a GVHD in Haploidentical Transplants. Subjects and methods; This Cohort Follow up study was conducted during the period from January 2020 to March 2023 and included 49 patients with different hematological malignancies indicated for Haploidentical bone marrow transplant who received Standard PTCy (50mg/kg) at Day +3,D+5 . Patients were recruited from BMT Unit in Maadi Armed Forces Medical Compound. Result; the Easix score, and the studied biomarkers increased significantly from baseline to D 7 of BMT, p <0.05. Easix score and other biomarkers increased significantly at Onset of a GVHD , there was correlation between Easix Pre and Overall survival , the rate of good steroid responsiveness among the GVHD patients was (54.9%), and the refractory response was (45.2%). there was a significant difference between serial Easix score measurements among GVHD patients, p<0.001. there was significant difference between good and refractory steroid responders regarding the mortality rate or cause. there was no significant relationship between the gut GVHD and 100-day survival rate, p>0.05. there was no significant relationship between the skin GVHD and 100-day survival rate, p>0.05. Conclusion; the current study showed that EASIX score was a good predictor for Onset of a GVHD and Overall survival in GVHD patients but was poor predictor of severity of disease and response to steroids in BMT patients. Also, inflammatory markers (IL-6, CRP and Ferritin) were reliable to predict the onset of a GVHD but nothing to do with response to steroids and mortality in BMT patients.