Stacey Goodman 3, John Greer 3, Adetola A. Kassim 3, ... Joseph H. Antin 5, Margaret L. MacMillan 2, Daniel J. Weisdorf 6,. Shernan Holtan 7. 1 Center for ...
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Abstracts / Biol Blood Marrow Transplant 22 (2016) S19eS481
BipinN. Savani 5, Wichai Chinratanalab3, Robert F. Cornell 5, Stacey Goodman 3, John Greer 3, Adetola A. Kassim 3, Salyka Sengsayadeth 3, Brian G. Engelhardt 3. 1 Medicine, Vanderbilt University Medical Center, Nashville, TN; 2 School of Medicine, Indiana University, Indianapolis, IN; 3 Vanderbilt University Medical Center, Nashville, TN; 4 Indiana University School of Medicine, Indianapolis, IN; 5 Division of Hematology/ Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN New-onset post-transplant diabetes mellitus (PTDM) is a common complication that can precede acute graft-versushost disease (aGVHD) and is associated with inferior survival after allogeneic hematopoietic cell transplantation (HCT). Glucose homeostasis and aGVHD are affected by IL-33 binding to its receptor, suppression of tumorigenicity 2 (ST2). Soluble ST2 (sST2) modulates the IL-33/ST2 axis and is a biomarker for aGVHD and non-relapse mortality (NRM). We hypothesize that PTDM and NRM are related to IL-33/ST2 signaling and that sST2 will predict PTDM diagnosis. Serum sST2 levels were measured by ELISA at engraftment and Day+30 in 36 euglycemic HCT recipients followed prospectively for PTDM (defined as weekly fasting blood glucose 3 126 mg/dL or random blood glucose 3200 mg/dLfrom day 0 to day+100). Results were confirmed in a validation cohort consisting of 26 patients (pt) without pre-existing diabetes retrospectively analyzed for PTDM (defined as random blood glucose 3200 mg/dl from day 0 to day+100).Pts with established diabetes were analyzed separately (n¼12). Table 1 defines characteristics. New-onset PTDM was diagnosed in 24 (67%) and 15 (58%) pts from cohorts 1 and 2, respectively. In cohorts 1 and 2, PTDM preceded grade 2-4 aGVHD in 12 and 8 individuals, respectively. When compared to recipients without PTDM, pts developing PTDM in cohort 1 had elevated sST2 levels at engraftment (39.5 ng/mL vs. 20 ng/mL; P¼0.02) and at day+30 (102 ng/mL vs. 22 ng/mL; P
