MAGIC biomarkers predict long term outcomes for steroid-resistant acute GVHD

Journal article

Publication Details

Author(s): Major-Monfried H, Renteria AS, Pawarode A, Reddy P, Ayuk F, Holler E, Efebera YA, Hogan WJ, Woelfl M, Qayed M, Hexner EO, Wudhikarn K, Ordemann R, Young R, Shah J, Hartwell MJ, Chaudhry M, Aziz M, Etra A, Yanik GA, Kroeger N, Weber D, Chen YB, Nakamura R, Rösler W, Kitko CL, Harris AC, Pulsipher M, Reshef R, Kowalyk S, Morales G, Torres I, Ozbek U, Ferrara JLM, Levine JE
Journal: Blood
Publication year: 2018
ISSN: 0006-4971


Acute graft versus host disease (GVHD) is treated with systemic corticosteroid immunosuppression. Clinical response after one week of therapy often guides further treatment decisions, but long term outcomes vary widely between centers and more accurate predictive tests are urgently needed. We analyzed clinical data and blood samples taken after one week of systemic treatment for GVHD from 507 patients from 17 centers of the Mount Sinai Acute GVHD International Consortium (MAGIC), dividing them into test (n=236) and two validation cohorts separated in time (n = 142 and 129, respectively). Initial response to systemic steroids correlated with response at four weeks, one-year non-relapse mortality (NRM) and overall survival (OS). A previously validated algorithm of two MAGIC biomarkers (ST2 and REG3α) consistently separated steroid resistant patients into two groups with dramatically different NRM and OS (p<0.001 for all three cohorts). High biomarker probability, resistance to steroids and GVHD severity (Minnesota risk) were all significant predictors of NRM in multivariate analysis. A direct comparison of receiver operating curves showed the area under the curve for biomarker probability (0.82) was significantly greater than that for steroid response (0.68, p=0.004) and for Minnesota risk (0.72, p=0.005). In conclusion, MAGIC biomarker probabilities generated after one week of systemic treatment for GVHD predict long term outcomes in steroid resistant GVHD better than clinical criteria and should prove useful in developing better treatment strategies.

FAU Authors / FAU Editors

Rösler, Wolf Dr. med.
Medizinische Klinik 5 - Hämatologie und Internistische Onkologie

External institutions with authors

Children's Hospital Los Angeles
Chulalongkorn University / จุฬาลงกรณ์มหาวิทยาลัย
City of Hope Medical Center
Columbia University
Emory University
Icahn School of Medicine at Mount Sinai
Julius-Maximilians-Universität Würzburg
Massachusetts General Hospital
Mayo Clinic
Ohio State University
Technische Universität Dresden
Universität Regensburg
Universitätsklinikum Heidelberg
University of Michigan
University of Pennsylvania
University of Utah
Vanderbilt University

How to cite

Major-Monfried, H., Renteria, A.S., Pawarode, A., Reddy, P., Ayuk, F., Holler, E.,... Levine, J.E. (2018). MAGIC biomarkers predict long term outcomes for steroid-resistant acute GVHD. Blood.

Major-Monfried, Hannah, et al. "MAGIC biomarkers predict long term outcomes for steroid-resistant acute GVHD." Blood (2018).


Last updated on 2018-15-11 at 21:08