Biomarkers for Graft-Versus-Host Disease in Hematopoietic Stem Cell Transplant Patients

Introduction: One of the therapeutic strategies for hematological malignancies is hematopoietic stem cell transplantation (HSCT). However, a common and severe post-transplantation complication is graft-versus-host disease (GVHD), primarily mediated by the donor’s immunocompetent cells, particularly T lymphocytes. Objectives: This study aims to explore potential biomarkers for the prognosis and diagnosis of GVHD following HSCT. Methods: This integrative review was conducted using the PubMed and Google Scholar databases. The research question was structured and refined using the PICO (Population, Intervention, Comparison, and Outcome) method, resulting in the guiding question: “Can biomarkers help in the diagnosis, prognosis, and treatment of GVHD?” The descriptors used were: “graft versus host disease,” “hematopoietic stem cell transplant,” and “microRNAs,” combined with the Boolean operator “AND.” These searches resulted in 1,942 articles, from which 33 were selected based on the English language and relevance to the main objectives of the study, after reviewing their titles and abstracts. Results: Among the biomarkers examined, microRNAs emerge as the most promising due to their stability and ease of extraction from body fluids. While some progress has been made in identifying such markers in recent years, further research is necessary to enhance understanding and ensure their practical application in clinical settings. Conclusion: The importance of finding biomarkers, considered more enlightening and less susceptible to bias compared to traditional diagnostic methods that can predict the risk of GVHD, is demonstrated. Although there are strategies to reduce the risk of developing this complication, such as T lymphocyte depletion, patients undergoing these therapies have a high risk of relapse since the effect called “graft-versus-leukemia” is compromised. Although the search for such markers has achieved some success in recent years, further studies are needed to provide additional clarification and ensure applicability in daily clinical practice. An ideal biomarker should be easily measurable, highly sensitive, and specific, enabling early detection using readily available samples.