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Acute Graft-versus-host disease(aGVDH) after allogeneic hematopoietic stem cell transplantation is one of the meaningful issues in aspect of patient's recovery and survival. in recent years, the understanding of the pathology of GVHD is much important to prevent or treat aGVHD. additionally, (oral) mucositis is one of the problems in patients with high dose chemotherapy, and mucositis by high-dose chemotherapy is related to HMGB-1 as proinflamtory cytokines. HMGB1 is a nuclear protein acts as a transcription factor, but, if it was released to the outside of cells by damaged cell or necrotic tissues, it works as cytokines for promoter of inflammation and cancers. at this point, there are no reported articles about correlation of HMGB1 and aGVHD in human. recently, we have seen excessive secretion of serum HMGB1 in mouse model, then base on this results, we will check correlation of HMGB1 and aGVHD/ oral mucositis in human.
materials 1) inclusion criteria
over 18-year-old
patients with myeloablative conditioning regimen
autologous transplant
patients with confirmation of acute GVHD as over grade II
patients with salvage chemotherapy
2) exclusion criteria
method 1) check the serum level of HMGB1, TNF-a, IL-1b, IL-6, Th1, Th2, Th17, FoxP3 on 7-day before transplant day(D-7), transplant day(D0), 7-day after transplant(D+7), D+14, D+21. 2) check the immunohistochemistry level of tissue in diagnosed aGVHD ( performed sigmoidoscopy and random biopsy of gut is routine process in our center) 3) check the oral mucositis grades (using WHO grading system, NCI -CTC ver.3 scoring system)
analysis 1) student t-test , chi-square test 2) survival analysis
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| high dose chemotherapy | group of using myeloablation regimen, autologous stell cell transplantation |
| |
| control group | normal population with health screening |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| salvage chemotherapy, total body irradiation | Drug | there are no direct interventions to our patients. |
|
| Measure | Description | Time Frame |
|---|---|---|
| comparison of serum HMGB1 level before and after diagnosed acute GVHD | day 7 before stem cell transplantation(SCT), day 0, day 7, 14 after SCT, and date of diagnosed acute GVHD in all patients. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| serum level of immunosuppressive drugs in patients with acute GVHD | day 7 before stem cell transplantation(SCT), day 0, day 7, 14 after SCT, and date of diagnosed acute GVHD in all patients. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| tissue IHC stain level of biopsy samples of diagnosed acute GVHD | if patients diagnosed with acute GVHD will be performed random biopy of colon or stomach. | |
| oral mucositis | find-out the correlation HMGB1 level and oral mucositis grading |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| young-woo JEON, bachelor, MD | Contact | 821042324067 |
| Name | Affiliation | Role |
|---|---|---|
| seok-goo CHO, M.D,Ph.D | The Catholic University of Korea | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul St.Mary's hospital | Recruiting | Seoul | 137701 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22760779 | Background | Brennan TV, Lin L, Huang X, Cardona DM, Li Z, Dredge K, Chao NJ, Yang Y. Heparan sulfate, an endogenous TLR4 agonist, promotes acute GVHD after allogeneic stem cell transplantation. Blood. 2012 Oct 4;120(14):2899-908. doi: 10.1182/blood-2011-07-368720. Epub 2012 Jul 3. | |
| 19819342 | Background | Kornblit B, Masmas T, Petersen SL, Madsen HO, Heilmann C, Schejbel L, Sengelov H, Muller K, Garred P, Vindelov L. Association of HMGB1 polymorphisms with outcome after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2010 Feb;16(2):239-52. doi: 10.1016/j.bbmt.2009.10.002. Epub 2009 Oct 9. |
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| ID | Term |
|---|---|
| D006086 | Graft vs Host Disease |
| D013280 | Stomatitis |
| ID | Term |
|---|---|
| D007154 | Immune System Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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| ID | Term |
|---|---|
| D014916 | Whole-Body Irradiation |
| ID | Term |
|---|---|
| D011878 | Radiotherapy |
| D013812 | Therapeutics |
| D008919 | Investigative Techniques |
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blood plasma biopsy tissue samples of colon
| 1 month |
| 22552293 | Background | Jube S, Rivera ZS, Bianchi ME, Powers A, Wang E, Pagano I, Pass HI, Gaudino G, Carbone M, Yang H. Cancer cell secretion of the DAMP protein HMGB1 supports progression in malignant mesothelioma. Cancer Res. 2012 Jul 1;72(13):3290-301. doi: 10.1158/0008-5472.CAN-11-3481. Epub 2012 May 2. |
| 23723299 | Background | Kang R, Zhang Q, Zeh HJ 3rd, Lotze MT, Tang D. HMGB1 in cancer: good, bad, or both? Clin Cancer Res. 2013 Aug 1;19(15):4046-57. doi: 10.1158/1078-0432.CCR-13-0495. Epub 2013 May 30. |