Changes in Serum Protein Profiles During Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT): Clinical Significance of Serum C-Reactive Protein and Haptoglobin Levels.

Successful hematopoietic stem cell transplantation involves the restoration of hematopoietic function after engraftment, arising from the differentiation and proliferation of hematopoietic stem cells. Several factors influence the course of allo-HSCT. In particular, knowledge of serum proteome changes during the allo-HSCT period might increase the efficacy of diagnosis and disease prevention efforts.

The sera from five representative patients who underwent allo-HSCT were analyzed by 2-DE and LC-MS/MS. To verify the clinical significance of identified serum proteome, we assessed the representative APPs, C-reactive protein (CRP) and haptoglobin in 78 patients who underwent allo-HSCT at Chonnam National University Hospital (CNUH) who were included between June 2002 and April 2008. Serum level of CRP and haptoglobin were measured weekly from D-7 or D-0 to D+21 of allo-HSCT.

Fourteen proteins showing significant changes in expression were further examined, and most were identified as APPs. Studies of 78 additional patients confirmed that CRP and haptoglobin undergo expression changes during allo-HSCT and thus have the potential to serve as representative markers of various hematologic diseases. Maximal CRP level affected the development of MTCs and other problems, FUO. In particular, an increase in CRP level 21 days after allo-HSCT was found to be an independent risk factor for MTC. Maximal haptoglobin and haptoglobin level 14 days after allo-HSCT were predictive of relapses in underlying hematologic disease.

Our results reveal the usefulness of a proteomic approach in the clinical follow-up of patients after allo-HSCT, and suggest that CRP and haptoglobin can be monitored after allo-HSCT to assess risks of early transplant-related complications and relapse.

No relevant conflicts of interest to declare.