ArticleBMC immunology2026
Dynamic immune profiling enables early distinction between gastrointestinal GVHD and viral diarrhea after hematopoietic stem cell transplantation.
Article in BMC immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAllogeneic hematopoietic stem cell transplantation (allo-HSCT) is curative for hematologic malignancies, yet diarrhea after allo-HSCT-mainly due to gastrointestinal graft-versus-host disease (GI-GVHD) or viral infection-remains a major clinical challenge. Early etiological differentiation is essential for appropriate management.
aimsThis study aimed to develop an immune-based predictive model by dynamically monitoring lymphocyte subsets and cytokines after allo-HSCT.
resultsAmong 232 patients who underwent allo-HSCT at Beijing Lu Daopei Hospital between 2021 and 2024, 58 developed biopsy-confirmed post-transplant (post-HSCT) diarrhea, comprising 34 cases of GI-GVHD and 24 cases of viral enteritis. Immune profiles were measured one week prior to diarrhea onset, as well as at weeks 4 and 5 post-HSCT. Predictive features were selected using LASSO and logistic regression to construct single- and multi-time-point models, which were validated using nomogram, calibration, and decision curve analyses. At the pre-diarrhea point, patients with aGVHD had higher Reg3α, CD3⁺T%, CD8⁺T%, naive CD4⁺/CD4⁺T%, and Th2/CD4⁺T%, but lower NK count and NK% (all P < 0.05). The single-time-point model achieved good discrimination (AUC = 0.799), while the multi-time-point model integrating nine dynamic parameters showed superior accuracy (AUC = 0.908).
conclusionsDynamic immune profiling may aid in the early distinction between GI-GVHD and viral enteritis, highlighting its potential as a tool for immunological surveillance to guide intervention after allo-HSCT.
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