Interleukin-5 is an adjunctive biomarker for engraftment syndrome in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation

Abstract

Autologous hematopoietic stem cell transplantation (ASCT) in multiple myeloma (MM) can cause engraftment syndrome (ES), a clinical diagnosis without specific laboratory biomarkers. Herein, six cytokines commonly elevated during transplantation were chronologically detected during ASCT in 96 patients with newly diagnosed MM, 24.0 % of whom experienced ES. Among the molecules demonstrating remarkable peak levels, only IL-5 was able to differentiate ES from non-ES. IL-5 measured on day 12 emerged as an optimal indicator of ES, and its diagnostic value was enhanced when combined with the proportion of endogenous CD8⁺ T cells after engraftment and daratumumab-naive history. Notably, IL-5 levels on day 6 (IL-5 D6) served as the earliest predictor. 70.8 % of the patients could be predicted as having ES or non-ES via the IL-5 D6 cutoff value and daratumumab treatment history. It suggests that IL-5 can aid in estimating ES, and prior exposure to daratumumab may reduce the incidence of ES.

Keywords: Autologous hematopoietic stem cell transplantation; Engraftment syndrome; Interleukin-5; Multiple myeloma.