COMPARISON BETWEEN SERUM AND FECAL CALPROTECTIN AS MARKER OF GRAFT-VERSUS-HOST DISEASE
(Abstract release date: 05/19/16)
EHA Library. Metafuni E. 06/09/16; 135096; PB2196
Dr. Elisabetta Metafuni
Contributions
Contributions
Abstract
Abstract: PB2196
Type: Publication Only
Background
Graft-versus-host disease (GvHD) is one of the complication occurring after hematopoietic stem cell transplantation (SCT) responsible for high morbility and mortality. The main strategy to reduce GvHD-related mortality is the correct diagnosis and prompt steroid administration. In the last few years, different proteins have been evaluated as reliable biomarker of GvHD. In our experience, fecal calprotectin (FC), a heterodimer of two S100 family proteins S100A8/S100A9 secreted by activated macrophages, appeared useful to differentiate gut GvHD from liver/skin GvHD, and to distinguish between gut GvHD and enteritis due to other causes.
Aims
The aim of our study was to compare fecal (FC) and serum (SC) levels of calprotectin in a cohort of patients (pts) submitted to SCT, in order to define if a correspondence there was between the two determinations in the same patient (pt).
Methods
We enrolled 21 pts submitted to SCT in our department since December 2009 al July 2012, 9 females and 12 males, with a median age of 55 years (range 35-63), affected by acute lymphoblastic leukemia in 2 cases, acute myeloid leukemia in 14 cases, non-Hodgkin lymphoma in 1 case, myeloproliferative disease in 1 case and myelodisplastic syndrome in 3 cases. Conditioning regimes was MAC in 2 pts and RIC in 19 pts. GvHD prophylaxis was performed with short course methotrexate plus CSA in 15 cases and with CSA+MMF in 6 pts. Donor was related in 14 cases and unrelated in 7 pts. Serum and stools samples were provided for each pt at the time of GvHD onset and, for pts who did not developed GvHD samples were collected around day +30. Calprotectin detection was made using commercial ELISA kit for Calprotectin assay on stools and serum samples.
Results
Fourteen pts (66,7%) developed acute GvHD after a median time of 25,5 days (range 6-80): grade I in 3 pts (21,4%), grade II in 3 pts (21,4%), grade III in 7 pts (50%) and grade IV in 1 pt (7,2%). Organ involvement was: isolated skin in three pts, skin and liver in one pt, isolated liver in 2 pts, isolated gut in 2 pts, gut and skin in 5 pts, skin and gut and liver in one pt. FC median level was 198,9 mg/Kg (range 58.4-500) in pts with aGvHD and 32.2 mg/Kg (range 15.6-89) in the others (Mann Whitney, p=0.0005, Fig 1A), while SC median level was 2756.5 ng/ml (range 173.3-10690) in pts with aGvHD and 1328 ng/ml (range 410.9-4241) in the others (Mann Whitney, p=0.22, Fig 1B). Among pts with aGvHD, FC median levels was 134.9 mg/Kg (range 58.4-292.3) in pts with grade I-II aGvHD and 396.6 mg/Kg (range 95.2-500) in grade III-IV (Mann Whitney, p=0.029), while SC median level was 231.2 ng/ml (range 173.3-5575) in pts with grade I-II aGvHD and 3601 ng/ml (range 868.5-10390) in grade III-IV (Mann Whitney, p=0.4). Finally, FC median level was 396.6 mg/Kg (range 142.1-500) in pts with gut aGvHD and 115.2 mg/Kg (range 58.4-292.3) for non-gut aGvHD (Mann Whitney, p=0.02, Fig 1C), while SC median level was 3232.25 ng/ml (range 868.5-10390) in pts with gut aGvHD and 2312 ng/ml (range 173.3-5575) in non-gut aGvHD (Mann Whitney, p=0.57, Fig 1D). Figure 1: A) median FC level in pts with (yes) or without (no) aGvHD; B) median SC level in pts with (yes) or without (no) aGvHD; C) median level of FC in pts with gut or liver/skin GvHD; D) median level of SC in pts with gut or liver/skin GvHD.
Conclusion
There was no correspondence between serum and fecal camprotectin. Our studies suggest that fecal but not serum calprotectin levels may be considered a marker of gut GvHD after SCT.
Session topic: E-poster
Keyword(s): Graft-versus-host disease (GVHD), Stem cell transplant
Type: Publication Only
Background
Graft-versus-host disease (GvHD) is one of the complication occurring after hematopoietic stem cell transplantation (SCT) responsible for high morbility and mortality. The main strategy to reduce GvHD-related mortality is the correct diagnosis and prompt steroid administration. In the last few years, different proteins have been evaluated as reliable biomarker of GvHD. In our experience, fecal calprotectin (FC), a heterodimer of two S100 family proteins S100A8/S100A9 secreted by activated macrophages, appeared useful to differentiate gut GvHD from liver/skin GvHD, and to distinguish between gut GvHD and enteritis due to other causes.
Aims
The aim of our study was to compare fecal (FC) and serum (SC) levels of calprotectin in a cohort of patients (pts) submitted to SCT, in order to define if a correspondence there was between the two determinations in the same patient (pt).
Methods
We enrolled 21 pts submitted to SCT in our department since December 2009 al July 2012, 9 females and 12 males, with a median age of 55 years (range 35-63), affected by acute lymphoblastic leukemia in 2 cases, acute myeloid leukemia in 14 cases, non-Hodgkin lymphoma in 1 case, myeloproliferative disease in 1 case and myelodisplastic syndrome in 3 cases. Conditioning regimes was MAC in 2 pts and RIC in 19 pts. GvHD prophylaxis was performed with short course methotrexate plus CSA in 15 cases and with CSA+MMF in 6 pts. Donor was related in 14 cases and unrelated in 7 pts. Serum and stools samples were provided for each pt at the time of GvHD onset and, for pts who did not developed GvHD samples were collected around day +30. Calprotectin detection was made using commercial ELISA kit for Calprotectin assay on stools and serum samples.
Results
Fourteen pts (66,7%) developed acute GvHD after a median time of 25,5 days (range 6-80): grade I in 3 pts (21,4%), grade II in 3 pts (21,4%), grade III in 7 pts (50%) and grade IV in 1 pt (7,2%). Organ involvement was: isolated skin in three pts, skin and liver in one pt, isolated liver in 2 pts, isolated gut in 2 pts, gut and skin in 5 pts, skin and gut and liver in one pt. FC median level was 198,9 mg/Kg (range 58.4-500) in pts with aGvHD and 32.2 mg/Kg (range 15.6-89) in the others (Mann Whitney, p=0.0005, Fig 1A), while SC median level was 2756.5 ng/ml (range 173.3-10690) in pts with aGvHD and 1328 ng/ml (range 410.9-4241) in the others (Mann Whitney, p=0.22, Fig 1B). Among pts with aGvHD, FC median levels was 134.9 mg/Kg (range 58.4-292.3) in pts with grade I-II aGvHD and 396.6 mg/Kg (range 95.2-500) in grade III-IV (Mann Whitney, p=0.029), while SC median level was 231.2 ng/ml (range 173.3-5575) in pts with grade I-II aGvHD and 3601 ng/ml (range 868.5-10390) in grade III-IV (Mann Whitney, p=0.4). Finally, FC median level was 396.6 mg/Kg (range 142.1-500) in pts with gut aGvHD and 115.2 mg/Kg (range 58.4-292.3) for non-gut aGvHD (Mann Whitney, p=0.02, Fig 1C), while SC median level was 3232.25 ng/ml (range 868.5-10390) in pts with gut aGvHD and 2312 ng/ml (range 173.3-5575) in non-gut aGvHD (Mann Whitney, p=0.57, Fig 1D). Figure 1: A) median FC level in pts with (yes) or without (no) aGvHD; B) median SC level in pts with (yes) or without (no) aGvHD; C) median level of FC in pts with gut or liver/skin GvHD; D) median level of SC in pts with gut or liver/skin GvHD.
Conclusion
There was no correspondence between serum and fecal camprotectin. Our studies suggest that fecal but not serum calprotectin levels may be considered a marker of gut GvHD after SCT.
Session topic: E-poster
Keyword(s): Graft-versus-host disease (GVHD), Stem cell transplant
Abstract: PB2196
Type: Publication Only
Background
Graft-versus-host disease (GvHD) is one of the complication occurring after hematopoietic stem cell transplantation (SCT) responsible for high morbility and mortality. The main strategy to reduce GvHD-related mortality is the correct diagnosis and prompt steroid administration. In the last few years, different proteins have been evaluated as reliable biomarker of GvHD. In our experience, fecal calprotectin (FC), a heterodimer of two S100 family proteins S100A8/S100A9 secreted by activated macrophages, appeared useful to differentiate gut GvHD from liver/skin GvHD, and to distinguish between gut GvHD and enteritis due to other causes.
Aims
The aim of our study was to compare fecal (FC) and serum (SC) levels of calprotectin in a cohort of patients (pts) submitted to SCT, in order to define if a correspondence there was between the two determinations in the same patient (pt).
Methods
We enrolled 21 pts submitted to SCT in our department since December 2009 al July 2012, 9 females and 12 males, with a median age of 55 years (range 35-63), affected by acute lymphoblastic leukemia in 2 cases, acute myeloid leukemia in 14 cases, non-Hodgkin lymphoma in 1 case, myeloproliferative disease in 1 case and myelodisplastic syndrome in 3 cases. Conditioning regimes was MAC in 2 pts and RIC in 19 pts. GvHD prophylaxis was performed with short course methotrexate plus CSA in 15 cases and with CSA+MMF in 6 pts. Donor was related in 14 cases and unrelated in 7 pts. Serum and stools samples were provided for each pt at the time of GvHD onset and, for pts who did not developed GvHD samples were collected around day +30. Calprotectin detection was made using commercial ELISA kit for Calprotectin assay on stools and serum samples.
Results
Fourteen pts (66,7%) developed acute GvHD after a median time of 25,5 days (range 6-80): grade I in 3 pts (21,4%), grade II in 3 pts (21,4%), grade III in 7 pts (50%) and grade IV in 1 pt (7,2%). Organ involvement was: isolated skin in three pts, skin and liver in one pt, isolated liver in 2 pts, isolated gut in 2 pts, gut and skin in 5 pts, skin and gut and liver in one pt. FC median level was 198,9 mg/Kg (range 58.4-500) in pts with aGvHD and 32.2 mg/Kg (range 15.6-89) in the others (Mann Whitney, p=0.0005, Fig 1A), while SC median level was 2756.5 ng/ml (range 173.3-10690) in pts with aGvHD and 1328 ng/ml (range 410.9-4241) in the others (Mann Whitney, p=0.22, Fig 1B). Among pts with aGvHD, FC median levels was 134.9 mg/Kg (range 58.4-292.3) in pts with grade I-II aGvHD and 396.6 mg/Kg (range 95.2-500) in grade III-IV (Mann Whitney, p=0.029), while SC median level was 231.2 ng/ml (range 173.3-5575) in pts with grade I-II aGvHD and 3601 ng/ml (range 868.5-10390) in grade III-IV (Mann Whitney, p=0.4). Finally, FC median level was 396.6 mg/Kg (range 142.1-500) in pts with gut aGvHD and 115.2 mg/Kg (range 58.4-292.3) for non-gut aGvHD (Mann Whitney, p=0.02, Fig 1C), while SC median level was 3232.25 ng/ml (range 868.5-10390) in pts with gut aGvHD and 2312 ng/ml (range 173.3-5575) in non-gut aGvHD (Mann Whitney, p=0.57, Fig 1D). Figure 1: A) median FC level in pts with (yes) or without (no) aGvHD; B) median SC level in pts with (yes) or without (no) aGvHD; C) median level of FC in pts with gut or liver/skin GvHD; D) median level of SC in pts with gut or liver/skin GvHD.
Conclusion
There was no correspondence between serum and fecal camprotectin. Our studies suggest that fecal but not serum calprotectin levels may be considered a marker of gut GvHD after SCT.
Session topic: E-poster
Keyword(s): Graft-versus-host disease (GVHD), Stem cell transplant
Type: Publication Only
Background
Graft-versus-host disease (GvHD) is one of the complication occurring after hematopoietic stem cell transplantation (SCT) responsible for high morbility and mortality. The main strategy to reduce GvHD-related mortality is the correct diagnosis and prompt steroid administration. In the last few years, different proteins have been evaluated as reliable biomarker of GvHD. In our experience, fecal calprotectin (FC), a heterodimer of two S100 family proteins S100A8/S100A9 secreted by activated macrophages, appeared useful to differentiate gut GvHD from liver/skin GvHD, and to distinguish between gut GvHD and enteritis due to other causes.
Aims
The aim of our study was to compare fecal (FC) and serum (SC) levels of calprotectin in a cohort of patients (pts) submitted to SCT, in order to define if a correspondence there was between the two determinations in the same patient (pt).
Methods
We enrolled 21 pts submitted to SCT in our department since December 2009 al July 2012, 9 females and 12 males, with a median age of 55 years (range 35-63), affected by acute lymphoblastic leukemia in 2 cases, acute myeloid leukemia in 14 cases, non-Hodgkin lymphoma in 1 case, myeloproliferative disease in 1 case and myelodisplastic syndrome in 3 cases. Conditioning regimes was MAC in 2 pts and RIC in 19 pts. GvHD prophylaxis was performed with short course methotrexate plus CSA in 15 cases and with CSA+MMF in 6 pts. Donor was related in 14 cases and unrelated in 7 pts. Serum and stools samples were provided for each pt at the time of GvHD onset and, for pts who did not developed GvHD samples were collected around day +30. Calprotectin detection was made using commercial ELISA kit for Calprotectin assay on stools and serum samples.
Results
Fourteen pts (66,7%) developed acute GvHD after a median time of 25,5 days (range 6-80): grade I in 3 pts (21,4%), grade II in 3 pts (21,4%), grade III in 7 pts (50%) and grade IV in 1 pt (7,2%). Organ involvement was: isolated skin in three pts, skin and liver in one pt, isolated liver in 2 pts, isolated gut in 2 pts, gut and skin in 5 pts, skin and gut and liver in one pt. FC median level was 198,9 mg/Kg (range 58.4-500) in pts with aGvHD and 32.2 mg/Kg (range 15.6-89) in the others (Mann Whitney, p=0.0005, Fig 1A), while SC median level was 2756.5 ng/ml (range 173.3-10690) in pts with aGvHD and 1328 ng/ml (range 410.9-4241) in the others (Mann Whitney, p=0.22, Fig 1B). Among pts with aGvHD, FC median levels was 134.9 mg/Kg (range 58.4-292.3) in pts with grade I-II aGvHD and 396.6 mg/Kg (range 95.2-500) in grade III-IV (Mann Whitney, p=0.029), while SC median level was 231.2 ng/ml (range 173.3-5575) in pts with grade I-II aGvHD and 3601 ng/ml (range 868.5-10390) in grade III-IV (Mann Whitney, p=0.4). Finally, FC median level was 396.6 mg/Kg (range 142.1-500) in pts with gut aGvHD and 115.2 mg/Kg (range 58.4-292.3) for non-gut aGvHD (Mann Whitney, p=0.02, Fig 1C), while SC median level was 3232.25 ng/ml (range 868.5-10390) in pts with gut aGvHD and 2312 ng/ml (range 173.3-5575) in non-gut aGvHD (Mann Whitney, p=0.57, Fig 1D). Figure 1: A) median FC level in pts with (yes) or without (no) aGvHD; B) median SC level in pts with (yes) or without (no) aGvHD; C) median level of FC in pts with gut or liver/skin GvHD; D) median level of SC in pts with gut or liver/skin GvHD.
Conclusion
There was no correspondence between serum and fecal camprotectin. Our studies suggest that fecal but not serum calprotectin levels may be considered a marker of gut GvHD after SCT.
Session topic: E-poster
Keyword(s): Graft-versus-host disease (GVHD), Stem cell transplant
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