DecodingAcute GVHD: The role of serum biomarkers and imaging in diagnosis and management.

Abstract

Graft-versus-host disease (GVHD) is one of the major barriers to the clinical success of hematopoietic stem cell transplantation (HCT). Despite improvements in GVHD incidence with the use of post-transplant cyclophosphamide, cord blood transplantation, and improvement in donor identification and matching, it remains a major cause of death in HCT. Early and accurate identification of GVHD is required to improve HCT outcomes. Diagnosis ambiguity continues to be problematic, despite improvements in PCR based stool studies, immunohistochemical markers in tissue biopsy, and improvement in histopathological examination. Unfortunately, therefore, early diagnosis of GVHD suffers from the lack of established diagnostic biomarkers which could improve prompt identification and treatment of GVHD at a time when therapeutic outcome is most impactful. This review discusses available diagnostic serum biomarkers and imaging advancements available to predict onset, severity, and prognosis in GVHD. Additionally, this review highlights the differential diagnosis of GVHD from other related pathological conditions.