High cutaneous amphiregulin expression predicts fatal acute graft-versus-host disease

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BACKGROUND: Amphiregulin (AREG) is increased in circulation in acute graft-versus-host disease (aGVHD) and is associated with poor steroid response and lower survival. The expression of AREG in aGVHD target organs and its association with clinical outcomes are unknown.

METHODS: We performed AREG immunohistochemical staining on skin specimens from 67 patients with aGVHD between the years 2010 and 2015. Two blinded reviewers assessed AREG expression and scored specimens with a semiquantitative scale ranging from 0 (absent) to 4 (most intense).

RESULTS: Median AREG score of aGVHD cases was 3. Sixteen of 67 (23.9%) aGVHD cases had an AREG >3. High skin AREG expression (>3 vs. ≤3) was associated with increased overall clinical grade of aGVHD (52.9% vs. 33.4% clinical grade III-IV, p = 0.02), reduced 3-year overall survival (OS; 13% vs. 61%, p < 0.01), and increased 3-year non-relapse mortality (NRM; 56% vs. 20%, p = 0.05).

CONCLUSION: High skin AREG immunohistochemical expression is associated with high clinical grade aGVHD, poor OS, and increased NRM.

Original languageEnglish (US)
Pages (from-to)532-535
Number of pages4
JournalJournal of cutaneous pathology
Issue number6
StatePublished - Jun 2022

Bibliographical note

Funding Information:
Masonic Cancer Center Pilot Grant program (SGH) and Marrow on the Move (SGH); Women's Early Research Career Award, the Department of Medicine, University of Minnesota Funding information

Publisher Copyright:
© 2022 The Authors. Journal of Cutaneous Pathology published by John Wiley & Sons Ltd.


  • acute GVHD
  • allogeneic hematopoietic cell transplantation
  • amphiregulin
  • epidermal growth factor

PubMed: MeSH publication types

  • Journal Article


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