Biomarkers for Early Complications of Endothelial Origin After Allogeneic Hematopoietic Stem Cell Transplantation: Do They Have a Potential Clinical Role?

Abstract

Endothelial cell (EC) dysfunction causes a number of early and life-threatening post hematopoietic stem cell transplant (HCT) complications that result in a rapid clinical decline. The main early complications are graft-vs.-host disease (GVHD), transplant associated thrombotic microangiopathy (TA-TMA), and sinusoidal obstruction syndrome (SOS). Post-HCT endothelial dysfunction occurs as a result of chemotherapy, infections, and allogeneic reactivity. Despite major advances in transplant immunology and improvements in supportive care medicine, these complications represent a major obstacle for successful HCT. In recent years, different biomarkers have been investigated for early detection of post-transplant endothelial cell dysfunction, but few have been validated. In this review we will define GVHD, TA-TMA and SOS, summarize the current data available in HCT biomarker research and identify promising biomarkers for detection and diagnosis of early HCT complications.

Keywords: GvHD; HCT; SOS; TA-TMA; biomarkers; endothelial dysfunction.

Figure 1

(A) Schematic illustrating ECs activation, damage and repair after allogeneic HCT. (B) Common markers of EC damage which can potentially be used for detection of early post-HCT complications of endothelial origin. CEC: circulating endothelial cells; EPCs: progenitor endothelial cells; EVs: extracellular vesicles; CAM and sCAM: cell adhesion molecules and soluble CAM; sSelectins: soluble Selectins.