Biomarkers in graft versus host disease after allogeneic hematopoietic stem cell transplant
Geary, Joshua J.
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Hematopoietic stem cell transplant was developed as a curative therapy to treat onco-hematological diseases and recently indications for this therapy have expanded to include solid tumors, hemoglobinopathies and other genetic diseases and disorders. Two major types of hematopoietic stem cell transplant have been developed. Autologous transplants aim to deliver a massive dose of radiation and/or chemotherapy that is capable of ablating the hematopoietic stem cells in the bone marrow. The patient is then "rescued" from this lethal dose of treatment by an infusion of their own hematopoietic stem cells. Allogeneic transplants are designed to either functionally replace a cell class, or an enzyme or biological function absent in the patient, or to consolidate a remission in a onco-hematological disease via the graft-versus-tumor effect . Two of the largest causes of non-relapse mortality from an allogeneic hematopoietic stem cell transplant are acute and chronic graft-versus-host disease, in which immune cells derived from the graft recognize normal host tissue as foreign and attack these tissues. A host of biomarkers for acute graft versus host disease have been identified, but there is almost none for chronic graft versus host disease. Herein, a methodology to discover and validate a biomarker(s) for the most common organ system affected by chronic graft versus host disease is proposed.