Interleukin-27: a biomarker for prediction of acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation from unrelated donors
Objective 
To analyze the predictive value of serum interleukin-27 (IL-27) for acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) from unrelated donors. 
 
 
Methods 
Serum samples were collected from 72 patients after receiving allo-HSCT from unrelated donors during January to December 2012. Serum samples collected from 70 patients received allo-HSCT in 2013 were used for confirmation. All patients received myeloablative conditioning regimen prior to allo-HSCT. Cyclosporin A (CsA)+ mycophenolate mofetil (MMF)+ short-term methotrexate (MTX) were used for GVHD prophylaxis. Serum IL-27 levels in patients with aGVHD were measured by ELISA. The predictive value of IL-27 index, defined as the ratio of serum IL-27 level at neutrophil engraftment to that before pre-conditioning regimen, for allogeneic HSCT was retrospectively analyzed. 
 
 
Results 
Serum IL-27 index was significantly decreased in patients with grade Ⅱ-Ⅳ aGVHD (grade 0-Ⅰ∶1.89±0.68 vs grade Ⅱ-Ⅳ∶1.26±0.49; P<0.000 1). IL-27 index had good value for grade Ⅱ-Ⅳ aGVHD (AUC=0.782, 95% CI: 0.675-0.889, P<0.001). Patients with a lower serum IL-27 index (<1.33) were more likely to have a higher cumulative incidence of grade Ⅱ-Ⅳ aGVHD than those with a higher serum IL-27 index (P<0.001). Multivariate analysis confirmed that low IL-27 index was the most significant risk factor for grade Ⅱ-Ⅳ aGVHD (HR=4.50, 95% CI: 2.1-9.8, P<0.01). These findings were consistent with the results found in the serum samples collected in 2013. 
 
 
Conclusion 
Low IL-27 index could be used to predict the incidence of grade Ⅱ-Ⅳ acute GVHD after allo-HSCT from unrelated donors. 
 
 
Key words: 
Biomarker; Graft-versus-host disease; IL-27; Unrelated donor transplantation