Predicting hepatic complications of allogeneic hematopoietic stem cell transplantation using liver stiffness measurement
| Autor: | Georg-Nikolaus Franke, Volker Keim, Janett Fischer, Tina Weiße, Thomas Karlas, M Tröltzsch, Dietger Niederwieser, Christine Döhring, Johannes Wiegand, David Petroff, Sebastian Beer, Joachim Mössner, Franziska Gnatzy, Gerhard Behre |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Hematopoietic stem cell transplantation Hepatic Complication Gastroenterology Disease-Free Survival 03 medical and health sciences Liver disease 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Humans Prospective Studies Prospective cohort study Survival rate Transplantation business.industry Liver Diseases Hazard ratio Hematopoietic Stem Cell Transplantation Hematology Stem-cell therapy Middle Aged medicine.disease Allografts Survival Rate Liver 030220 oncology & carcinogenesis Elasticity Imaging Techniques Female Transient elastography business 030215 immunology |
| Zdroj: | Bone marrow transplantation. 54(11) |
| ISSN: | 1476-5365 |
| Popis: | Allogeneic hematopoietic stem cell transplantation is the only curative option for a variety of diseases. Despite advances, it is associated with considerable morbidity and mortality, often involving liver complications. Liver disease can be characterized using ultrasound-based liver stiffness measurement. To assess its prognostic value, consecutive patients undergoing allogeneic hematopoietic stem cell transplantation were prospectively evaluated in a single-center study. Endpoints included liver event-free survival and all-cause mortality at 1 year. Competing risk and Cox-regression were used for analysis. We evaluated 106 patients (42 female, age 57) and observed 33 life-threatening events (14 died) including 16 liver complications at 100 days. At 1 year, 36 patients had died, 20 with disease relapse. The hazard ratios for liver-related complications at 100 days were 3.2 (95% CI: 1.8–14.6, p = 0.0022) and 4.4 (95% CI: 1.6–11.9, p = 0.0042) for elevated transient elastography (n = 11) and shear-wave velocity (n = 31), respectively. Results were analogous for all-cause mortality at 1 year. Prior stem cell therapy and elevated gamma glutamyltransferase were also associated with outcome. This demonstrates that elastography is a promising and viable tool for risk prediction and should be included in upcoming multi-center trials to establish new means of guiding treatment and prophylaxis. |
| Databáze: | OpenAIRE |
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