Precision diagnostics and novel biomarkers improve the management of graft-versus-host disease clinical spectrum
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Key Takeaway
Note the integration of ST2/REG3α MAGIC panels and transcriptomic profiling in advancing GVHD precision diagnostics.
This guideline outlines the clinical spectrum of graft-versus-host disease (GVHD), encompassing acute, chronic, and overlap syndromes according to NIH Consensus Criteria. It synthesizes current knowledge regarding the underlying pathogenesis, specifically identifying extracellular vesicles and a loss of gut microbiota diversity as critical drivers of the disease.
The document highlights advancements in precision diagnostics, including the ST2/REG3α MAGIC biomarker panel, novel B-cell subsets (cGPS) from the CD27+CD86+CD20- population, and transcriptomic profiling via scRNA-seq and cfRNA. These tools are presented as key components of the evolving diagnostic landscape.
Regarding the therapeutic landscape, the guideline incorporates 2024 prophylaxis recommendations and identifies newly approved treatments for steroid-refractory disease. While it provides a structured overview of clinical management and emerging technologies, the scope is limited to summarizing existing knowledge rather than reporting new primary data. These findings may assist clinicians in navigating complex GVHD cases.
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View Original Abstract ↓
Graft-versus-host disease (GVHD) remains a leading cause of non-relapse mortality after allogeneic hematopoietic stem cell transplantation (HSCT). This review provides a concise overview of the clinical spectrum of GVHD, including classical acute GVHD (aGVHD), chronic GVHD (cGVHD), and overlap syndromes as defined by the NIH Consensus Criteria. We summarize key advances in precision diagnostics, including the ST2/REG3α MAGIC biomarker panel, novel B-cell subsets (cGPS), which derive from a CD27+CD86+CD20- B-cell subpopulation, and transcriptomic profiling using single-cell RNA sequencing (scRNA-seq) and plasma cell-free RNA (cfRNA). We also examine extracellular vesicles and loss of gut microbiota diversity as critical drivers of pathogenesis. Finally, we analyze the current therapeutic landscape, distinguishing between 2024 prophylaxis recommendations and newly approved treatments for steroid-refractory disease.
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