Liver Stiffness Measurement Allows Early Diagnosis of Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome in Adult Patients Who Undergo Hematopoietic Stem Cell Transplantation: Results from a Monocentric Prospective Study

Autor: Amanda Vestito, Elton Dajti, Francesco Barbato, Federico Ravaioli, Vanessa Luigina Alemanni, Rocco Maurizio Zagari, Mariarosaria Sessa, Giovanni Marasco, Davide Festi, Mario Arpinati, Francesca Bonifazi, Antonio Colecchia, Michele Cavo
Přispěvatelé: Alma Mater Studiorum Universita' di Bologna, DIPARTIMENTO DI MEDICINA CLINICA, DIPARTIMENTO DI MEDICINA SPECIALISTICA, DIAGNOSTICA E SPERIMENTALE, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA
Rok vydání: 2019
Předmět:
Adult
medicine.medical_specialty
Time Factors
Hepatic veno-occlusive disease
Elastography
FibroScan
Sinusoidal obstruction syndrome
Ultrasonography
Ultrasound
medicine.medical_treatment
Hepatic Veno-Occlusive Disease
Hematopoietic stem cell transplantation
Sensitivity and Specificity
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Prospective Studies
Prospective cohort study
Survival rate
Transplantation
Receiver operating characteristic
business.industry
Hematopoietic Stem Cell Transplantation
Hematology
medicine.disease
Early Diagnosis
surgical procedures
operative
Liver
Area Under Curve
030220 oncology & carcinogenesis
Elasticity Imaging Techniques
Veno-Occlusive Disease
Transient elastography
Complication
business
030215 immunology
Zdroj: Biology of Blood and Marrow Transplantation. 25:995-1003
ISSN: 1083-8791
Popis: open 13 no Veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a life-threatening complication affecting patients undergoing hematopoietic stem cell transplantation (HSCT). The survival rate is higher when specific therapy is initiated early; thus, improving early, noninvasive diagnosis of VOD/SOS is an important need. In an adult population undergoing HSCT, we aimed to assess the role of liver stiffness measurement (LSM), evaluated by transient elastography (TE), for diagnosing VOD/SOS. Between April 2016 and March 2018, 78 consecutive adult patients with indications for allogeneic HSCT were prospectively included. LSM was performed before HSCT and at days +9/10, +15/17, and +22/24 post-HSCT. New European Society for Blood and Marrow Transplantation criteria were used to establish VOD/SOS diagnosis. Four patients developed VOD/SOS (5.1%) during the study period, with a median time of +17 days post-HSCT. A sudden increase in LSM compared with previously assessed values and pre-HSCT values, was seen in all patients who developed VOD/SOS. LSM increases occurred from 2 to 12 days before clinical SOS/VOD appearance. The VOD/SOS diagnostic performance of increased LSM over pre-HSCT assessment showed an area under the receiver operating characteristic curve of 0.997 (sensitivity 75%; specificity 98.7%). LSM gradually decreased following successful VOD/SOS-specific treatment. Interestingly, LSM values did not increase significantly in patients experiencing hepatobiliary complications (according to the Common Terminology Criteria) other than VOD/SOS. LSM by TE can be considered a promising method to perform an early, preclinical diagnosis and follow-up of VOD/SOS. open open Antonio, Colecchia; Federico, Ravaioli; Mariarosaria, Sessa; Vanessa, Alemanni Luigina; Elton, Dajti; Giovanni, Marasco; Amanda, Vestito; Maurizio, Zagari Rocco; Barbato, Francesco; Mario, Arpinati; Michele, Cavo; Davide, Festi; Francesca, Bonifazi Antonio, Colecchia; Federico, Ravaioli; Mariarosaria, Sessa; Vanessa, Alemanni Luigina; Elton, Dajti; Giovanni, Marasco; Amanda, Vestito; Maurizio, Zagari Rocco; Barbato, Francesco; Mario, Arpinati; Michele, Cavo; Davide, Festi; Francesca, Bonifazi
Databáze: OpenAIRE
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