Acute graft versus host disease (aGvHD) is a severe and potentially fatal complication of
allogeneic hematopoietic stem cell transplantation (HCT). The Mount Sinai Acute GVHD
International Consortium (MAGIC) algorithm probability (MAP) identifies patients who are at
high risk for severe aGvHD as early as 7 days after HCT based on 2 serum biomarkers,
suppressor of tumorigenesis 2 (ST2) and regenerating islet-derived 3α (Reg3α). Patients who
consent to this study will have their blood tested weekly up to four times within the first
month post HCT to determine if they are at high risk for severe GVHD based on MAP. Patients
who are at high risk at any of these four tests will be treated with methylprednisolone to
see if it prevents the development of severe aGvHD. Methylprednisolone starts with the dose
of 2 mg/kg for 5 days. If no signs of aGvHD, the dose of methylprednisolone is gradually
tapered within the following 16 days. Patients will be followed for the development of severe
aGvHD for up to 3 months from the HCT and will continue to be followed at routine clinic
visits for up to one year after HCT.