More than half of transplant recipients in a large analysis developed chronic graft-versus-host disease, and 15% died from causes other than cancer relapse. Those numbers capture the uneasy truth of allogeneic hematopoietic cell transplantation. The cure can come with a long, uncertain tail. Chronic graft-versus-host disease, or cGVHD, happens when donor immune cells attack the patient’s healthy tissues. It can injure the skin, eyes, mouth, joints, and lungs. Moreover, it remains a leading cause of debilitating illness and nonrelapse mortality after transplant. A research team led by Sophie Paczesny, M.D., Ph.D., at MUSC Hollings Cancer Center, worked with Michael Martens, Ph.D., and Brent Logan, Ph.D., at the Center for International Blood and Marrow Transplant Research at the Medical College of Wisconsin. The team set out to catch that danger earlier. Their new work in the Journal of Clinical Investigation describes BIOPREVENT, a machine learning tool designed to estimate a patient’s future risk of developing cGVHD and of dying without relapse. They used blood biomarkers and routine clinical factors. Sophie Paczesny, M.D., Ph.D., right with staff …