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BACKGROUND: There are few studies, especially in China, addressing the correlation between exosome miRNAs and graft-versus-host disease (GVHD) following human hematopoietic stem cell transplantation. Exosome-derived nucleic acid molecules are expected to become new biomarkers for predicting the occurrence of acute GVHD (aGVHD). OBJECTIVE: To investigate the differential expression of candidate gene microRNAs in peripheral blood serum exosomes of aGVHD patients with after allogeneic hematopoietic stem cell transplantation. METHODS: A total of 30 patients with aGVHD and without aGVHD after allogeneic hematopoietic stem cell transplantation from August 2017 to May 2018 were enrolled, including 20 in aGVHD group and 10 in non-aGVHD group. Serum exosomes and miRNAs were extracted before and after transplantation. Image acquisition and data analysis were performed after gene chip hybridization. RESULTS AND CONCLUSION: After microarray hybridization microRNAs showed an over 10-fold upward or downward trend before and after transplantation. Compared with the control group, 11 microRNAs increased and 26 decreased in the aGVHD group. hsa-miR-3976, hsa-miR-122-5p, and hsa-miR-3125 were significantly up-regulated, while hsa-miR-941, hsa-miR-4687-5P and hsa-miR-4769-5p were significantly down-regulated. [ABSTRACT FROM AUTHOR]