The role of serum uric acid in the prediction of graft-versus-host disease in allogeneic hematopoietic stem cell transplantation

Abstract

Background: Uric acid (UA) level is of the valuable signs of inflammation. However, the role of UA in the outcomes of hematopoietic stem cell transplantation (HSCT) such as GVHD and patients’ overall survival is still a matter of debate. In this study, we aimed to evaluate the relationship between UA levels and GVHD incidence and overall survival in allogeneic HSCT patients. Methods: A total of 201 patients who were admitted for allogeneic transplantation at Taleghani hospital, Tehran, Iran, were considered for retrospective analysis. Serum UA levels from 1 week before transplantation until 2 weeks after transplantation were used to determine thresholds and find out the association of serum UA levels with GVHD and overall survival. Results: We showed that the determined thresholds using receiver operating characteristic curves have poor predictive value for GVHD and overall survival. The patients with serum UA higher than 3.4 mg/dL had 37% lower odds of GVHD incidence and 35% lower hazard of death than patients with UA lower than 3.4 mg/dL. Conclusion: Our results indicated that serum UA levels lower than 3.4 mg/dL could significantly increase the incidence of GVHD and hazard of death. The antioxidant functions of UA could explain the lower incidence of GVHD in hyperuricemic patients. However, the inconsistencies of the previous studies require further investigation to elucidate the role of UA in the prediction of GVHD.