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Although oxidative stress is considered to contribute to the development of acute graft\u2010versus\u2010host disease (GVHD), the clinical significance of TXN remains to be elucidated. The current study included 118 patients who had undergone their first allogeneic haematopoietic stem cell transplantation (allo\u2010HSCT) between 2022 and 2025, and their serum samples at day 0 were sequentially collected (training cohort). The study also assessed 47 patients who had undergone their first allo\u2010HSCT between 2012 and 2015 and whose serum at around day 0 had previously been cryopreserved and was available (validation cohort). The high\u2010TXN group showed a lower cumulative incidence of grade II\u2013IV acute GVHD (100\u2010day incidence: 47.5% vs. 59.2%), although the difference did not reach statistical significance (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.058). The validation cohort demonstrated similar results (0% vs. 35.8%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.053). However, multivariate analysis revealed that high\u2010TXN group was significantly associated with a reduced risk of acute GVHD (hazard ratio [HR] 0.48,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.031). In addition, the combination of TXN with clinical factors enhanced the predictive potential for acute GVHD compared with that of clinical factors alone (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0039). TXN might be useful for predicting acute GVHD and could contribute to the establishment of a prediction model.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70739","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T03:54:27Z","timestamp":1788753267000},"page":"1762-1772","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum thioredoxin at allogeneic haematopoietic stem cell transplantation predicts acute graft\u2010versus\u2010host disease"],"prefix":"10.1111","volume":"209","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5899-7913","authenticated-orcid":false,"given":"Masaharu","family":"Tamaki","sequence":"first","affiliation":[{"name":"Division of Hematology Jichi Medical University Saitama Medical Center  Saitama Japan"},{"name":"Division of Emerging Medicine for Integrated Therapeutics, Center for Molecular Medicine Jichi Medical University  Shimotsuke 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