# Prognostic biomarkers for respiratory failure post hematopoietic cell transplantation

> **NIH NIH K23** · INDIANA UNIVERSITY INDIANAPOLIS · 2021 · $179,267

## Abstract

PROJECT SUMMARY
 While hematopoietic cell transplantation (HCT) is a life-saving therapy for previously fatal malignant and
nonmalignant conditions, pulmonary complications such as respiratory failure (RF) remain a barrier. Currently
there is no objective way to determine risk of developing RF, thereby limiting opportunities for early intervention
and prevention. We have identified 3 biomarkers, including stimulation 2 (ST2, the IL-33 receptor), interleukin 6
(IL-6), and tumor necrosis factor receptor 1 (TNFR1), which hold extreme promise for prognosis of future
occurrence of RF when measured as early as day 7 post HCT, well before typical onset of clinical respiratory
symptoms. Furthermore, we have conducted the two phases of proteomic discovery using mass spectrometry
and have identified 11 additional candidate biomarkers, in addition to ST2, to validate in an independent cohort.
Therefore, we hypothesize that prognostic biomarkers can serve as an early warning for the HCT recipient at
increased risk for RF. In Aim 1, we propose to investigate the effect of dynamic changes of validated biomarkers
at days 0, 7, 14, and 21 post-HCT on prognosis for RF. We will then, in Aim 2, validate additional diagnostic and
prognostic candidate biomarkers for RF discovered through our proteomics pipeline. Finally, in Aim 3, we will
conduct a prospective real-time multicenter study to determine RF prognostic biomarkers thresholds for enabling
a biomarker-based preemptive trial In addition to elucidating biologic etiologies of RF that could lead to improved
targeted therapies, this work will lay the foundation for a biomarker-based preemptive clinical trial aimed to
reduce RF and RF-related mortality post-HCT.
 During the award period, I will conduct research at Indiana University School of Medicine under the
primary mentorship of Dr. Sophie Paczesny and the remainder of the co-mentors, advisors and collaborators
outlined in the career development plan. I will focus on gaining critical skills in translational research needed to
successfully compete for NIH-funding and launch an independent research career. Specifically, I will develop a
comprehensive knowledge of clinical biomarker development, proteomic discovery using mass spectrometry,
advanced statistical methods to approach biomarker research including prognostic modeling, and skills in
implementation science to be able to translate these discoveries into clinical practice. With expertise in acute
respiratory failure post-HCT, experience leading multicenter collaborative clinical research studies in this
population, and a strong team of mentors and advisors, I am uniquely positioned to successfully complete the
proposed study and transition to an independent research career.

## Key facts

- **NIH application ID:** 10246522
- **Project number:** 5K23HL150244-02
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Courtney Rowan
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $179,267
- **Award type:** 5
- **Project period:** 2020-09-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10246522

## Citation

> US National Institutes of Health, RePORTER application 10246522, Prognostic biomarkers for respiratory failure post hematopoietic cell transplantation (5K23HL150244-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10246522. Licensed CC0.

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