en Hematology Hematology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:200%"><span new="" roman="" times=""><span style="color:#0033ff;"><em><strong>Background:</strong></em></span><span style="background:yellow"><span style="background-color:#ffffff;">Allogeneic hematopoietic stem cell transplantation (allo-HSCT) offers curative potential for hematologic malignancies, yet acute graft-versus-host disease (aGVHD) remains a major complication. Long non-coding RNAs (lncRNAs) regulate immune responses and T-cell differentiation, raising interest in their possible role as biomarkers. This study aimed to evaluate the expression of RUNX1-IT1 and AK026392.1 in peripheral CD4⁺ T cells of allo-HSCT recipients with and without aGVHD.</span></span></span></span><br> <span style="line-height:200%"><span new="" roman="" times=""><strong><span style="color:#0033ff;"><em>Methods:</em></span>&nbsp;</strong>In a case&ndash;control design, 30 acute leukemia patients undergoing allo-HSCT were enrolled. Peripheral blood samples were obtained on day +7 post-transplantation. Patients were monitored for 100 days and classified as aGVHD (n=14) or non-GVHD (n=16) according to NIH criteria. Expression levels of RUNX1-IT1 and AK026392.1 were quantified using qRT-PCR and normalized to ABL. Statistical comparisons and ROC curve analyses were performed to assess diagnostic performance.</span></span><br> <span style="line-height:200%"><span new="" roman="" times=""><strong><span style="color:#0033ff;"><em>Results:</em></span>&nbsp;</strong>RUNX1-IT1 expression was significantly elevated in the aGVHD group (~14-fold increase, P=0.012) with an AUC of 0.75, sensitivity 64.3%, and specificity 75%. AK026392.1 showed no statistically significant difference (P=0.114) but demonstrated relatively high specificity (87.5%) with an AUC of 0.67. No significant differences in baseline demographic or clinical characteristics were observed between groups.</span></span><br> <span style="line-height:200%"><span new="" roman="" times=""><span style="color:#0033ff;"><em><strong>Conclusion:&nbsp;</strong></em></span>RUNX1-IT1 upregulation in aGVHD patients supports its potential role in Th1-driven immune responses post-allo-HSCT. While AK026392.1 alone was not significant, its high specificity suggests value in combination with RUNX1-IT1 within multi-marker biomarker panels for aGVHD.</span></span></span></span> Hematopoietic Stem Cell Transplantation, Graft vs Host Disease, RNA, Long Noncoding, T-Lymphocytes, Leukemia, Acute 17 0 http://caspjim.com/browse.php?a_code=A-10-3284-3&slc_lang=en&sid=1 Mahsa Dabir mahsa.dabir9816@gmail.com 100319475328460056481 0009-0000-5159-5591 No Department of Medical Laboratory Science, School of Paramedical, Kermanshah University of Medical Sciences, Kermanshah Iran Shervin Manteghi hervinmanteghi20011379@gmail.com 100319475328460056482 100319475328460056482 No Department of Medical Laboratory Science, School of Paramedical, Kermanshah University of Medical Sciences, Kermanshah Iran Mehrdad Payandeh md.payandeh@yahoo.com 100319475328460056483 100319475328460056483 No Department of Hematology and Medical Oncology, Kermanshah University of Medical Sciences, Kermanshah, Iran Amir Abbas Rashidi Drarashidi@gmail.com 100319475328460056484 100319475328460056484 No Department of Hematology and Medical Oncology, Kermanshah University of Medical Sciences, Kermanshah, Iran Fakhredin Saba Fakhredin.saba@kums.ac.ir 100319475328460056485 100319475328460056485 Yes Department of Medical Laboratory Science, School of Paramedical, Kermanshah University of Medical Sciences, Kermanshah Iran