Neopterin Levels in Pediatric Allogeneic Hematopoietic Stem Cell Transplantation: A Potential Biomarker for Acute Graft-Versus-Host Disease?
Transplantation Proceedings, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.transproceed.2026.04.038
- Dergi Adı: Transplantation Proceedings
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO)
- Gazi Üniversitesi Adresli: Evet
Özet
Introduction: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for hematologic disorders. Acute graft-versus-host disease (aGVHD) remains a major cause of nonrelapse mortality. Distinguishing aGVHD from early post-transplant complications is challenging. This study evaluated serum neopterin (Np) as a potential early biomarker in pediatric patients. Methods: Forty-five pediatric allo-HSCT patients with available serum samples were included. Clinical, laboratory, and transplant-related parameters were retrospectively assessed. Patients were categorized by aGVHD status. Blood samples for Np measurement were collected on days 0, 7, and 28 post-transplant and stored at –80°C. Normal Np was defined as <10 nmol/L. Results: Patients (18 female, 27 male; mean age 8.97 ± 4.82 years) underwent HSCT for acute lymphoblastic leukemia (ALL) (n: 12), acute myeloblastic leukemia (AML) (n: 9), thalassemia major (TM) (n: 10), severe aplastic anemia (sAA) (n: 9), hemophagocytic lymphohistiocytosis (HLH) (n: 2), biphenotypic leukemia (BL) (n: 1) and inborn errors of metabolism (IEM) (n: 2). Twenty-three developed aGVHD. No significant differences were observed between patients with and without aGVHD regarding age, sex, diagnosis, ABO incompatibility, HLA matching, stem cell source, infused CD34+ and CD3+ cells, myeloid and platelet engraftment, or Np levels on days 0, 7, and 28. In all patients, levels were higher on day 28 than on day 7. Conclusions: Early detection and treatment of aGVHD after HSCT is crucial for reducing morbidity and mortality. Although no significant correlation between Np and aGVHD was observed, larger studies are warranted.