Influence of Ceacams Expression in Graft-Versus-Host Disease After Allogeneic Transplantation

The carcinoembryonic antigen (CEA) family is involved in intercellular binding interactions that affect various normal and pathogenic processes associated with cellular growth and differentiation. In human, the CEA family are subdivided into the CEA-related cell-adhesion molecules (CEACAMs) and the pregnancy-specific glycoproteins (PSGs). Never before the influence of CEACAMs on patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) was evaluated.

Here we analyzed in a retrospective study 33 patients (pts) for CEACAMs expression that underwent allogeneic HSCT for various diseases and analyzed their outcome. CEACAMs expressions were performed by flow cytometry and ELISA in whole blood, serum and urine samples.

We report the analysis of 19 pts with acute leukemia (58%), 5 pts with chronic leukemia (15%), 4 pts with MDS (12%) and 5 pts with advanced NHL (15%). The median age at transplant was 50.5 (range, 18–69) years. In this cohort 12 pts received grafts from HLA-identical siblings (36%), 16 pts from matched (49%) and 5 pts from mismatched (15%) unrelated donors. Transplantat consisted of unmanipulated peripheral blood stem cells (n=26, 79%) or bone marrow (n=7, 21%). Of all pts, 7 (21%) had relapsed after transplant. Among these pts, 31 (94%) developed acute GVHD (21 pts had an acute GvHD of grade ≥2). There was no significant correlation between CEACAMs expression after transplant between the variant leukemic disorders in the whole blood and the urine samples. Analysis of each CEACAMs for relapse showed no statistically differences. For CEACAM-6, we found a moderate up-regulation in pts with acute GvHD ≥2 versus acute GvHD <2 (p<0.1). In pts with severe acute GVHD (grade >3) comparing all other pts, we found significant induction of CEACAM-1 (118.5 ng/ml vs. 198.3 ng/ml, p<0.05) in urine samples and CEACAM-1 (109.2 vs. 157.5 ng/ml, p<0.04) in serum samples. However, no statistic differences were found in the CEACAM-1 in regards to chronic GVHD.

These results suggest that pts with high levels of CEACAM-1 confirms a relevant association of the development of acute GVHD and CEACAM profiling could be an early indicator of severe acute GvHD.

No relevant conflicts of interest to declare.