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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a clinically challenging modality for the treatment of many hematologic diseases such as leukemia, lymphoma, and myeloma. Graft-versus-host disease (GVHD) is a common complication after allo-HSCT and remains a major cause of morbidity and mortality, limiting the success of a potentially curative transplant. Several microRNAs (miRNAs) have recently been shown to impact the biology of GVHD. They are molecular regulators involved in numerous processes during T-cell development, homeostasis, and activation, and contribute to the pathological function of T-cells during GvHD.
Acute and chronic GVHD represent the main specific post-transplant complications affecting a patient’s life. The crucial point that distinguishes acute from chronic is the time of onset, followed by different clinical features, and above all the immunopathological mechanisms [34]. Acute GVHD (aGVHD) develops within the first 100 days posttransplant and affects the gastrointestinal tract, liver, skin, eyes, and oral mucosa as target organs [35]. Chronic GVHD (cGVHD) represents a delayed complication associated with transplantation and significantly reduced quality of life because it is a complicated multiorgan inflammatory syndrome [36]. Thus, timely diagnosis of GVHD is very important for patient outcomes as it is the main question that researchers seek to answer, and for this reason early biomarkers must be discovered for the prevention of transplant-associated morbid complications [37].
The discovery of miRNAs has triggered intense research to determine their role in normal and malignant haematopoiesis. The altered miRNA levels in cancer and healthy cells allow for the potential use of circulating miRNAs as diagnostic biomarkers. Researchers wanted to highlight the advances reported in the literature regarding circulating miRNA levels in plasma or EVs, which represent a promising tool not only for aGVHD but also for the diagnosis, prognosis, and prediction of cGVHD. Therefore, miRNAs represent the future of diagnostics and monitoring of many diseases and studying them and getting to know this world is essential for scientific progress.