Masaharu Tamaki, Hideki Nakasone, Kosuke Takano, Shunto Kawamura, Yukiko Misaki, Kazuki Yoshimura, Yosuke Okada, Aki Tanihara, Koki Hashino, Kaisuke Yamamoto, Yuya Nakata, Takuto Ishikawa, Akari Matsuoka, Tomohiro Meno, Yuhei Nakamura, Masakatsu Kawamura, Junko Takeshita, Nozomu Yoshino, Ayumi Gomyo, Machiko Kusuda, Shun-Ichi Kimura, Shinichi Kako, Yoshinobu Kanda
Thioredoxin (TXN) is a component of a major reductive system in various eukaryotes. Although oxidative stress is considered to contribute to the development of acute graft-versus-host disease (GVHD), the clinical significance of TXN remains to be elucidated. The current study included 118 patients who had undergone their first allogeneic haematopoietic stem cell transplantation (allo-HSCT) between 2022 and 2025, and their serum samples at day 0 were sequentially collected (training cohort). The study also assessed 47 patients who had undergone their first allo-HSCT between 2012 and 2015 and whose serum at around day 0 had previously been cryopreserved and was available (validation cohort). The high-TXN group showed a lower cumulative incidence of grade II-IV acute GVHD (100-day incidence: 47.5% vs. 59.2%), although the difference did not reach statistical significance (p = 0.058). The validation cohort demonstrated similar results (0% vs. 35.8%, p = 0.053). However, multivariate analysis revealed that high-TXN group was significantly associated with a reduced risk of acute GVHD (hazard ratio [HR] 0.48, p = 0.031). In addition, the combination of TXN with clinical factors enhanced the predictive potential for acute GVHD compared with that of clinical factors alone (p = 0.0039). TXN might be useful for predicting acute GVHD and could contribute to the establishment of a prediction model.