ST2 and Endothelial Injury as a Link between GVHD and Microangiopathy

Some patients with high ST2 levels, a marker for endothelial injury that is seen in graft-versus-host disease (GVHD), may have a response to treatment aimed at thrombotic microangiopathy. To the Editor: Vander Lugt et al. (Aug. 8, 2013, issue) 1 report an association between elevated levels of ST2 protein, a marker of endothelial injury, at the time of diagnosis of graft-versus-host disease (GVHD) and resistance to glucocorticoid therapy among the recipients of hematopoietic stem-cell transplantation (HSCT). The authors found a strong association between ST2 levels at day 14 after transplantation, a point well before the onset of GVHD, and the rate of death at 6 months among patients without a relapse in disease, but the cause of increased mortality was not clear. Transplant-associated thrombotic microangiopathy (TA-TMA) is triggered by . . .