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.

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 / 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. - In: BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION. - ISSN 1083-8791. - ELETTRONICO. - 25:5(2019), pp. 995-1003. [10.1016/j.bbmt.2019.01.019]

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

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
2019

Abstract

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.
2019
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 / 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. - In: BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION. - ISSN 1083-8791. - ELETTRONICO. - 25:5(2019), pp. 995-1003. [10.1016/j.bbmt.2019.01.019]
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
File in questo prodotto:
File Dimensione Formato  
2019_Colecchia A. Ravaioli F. et al, LSM Allows Early Diagnosis of VOD in adult patients who undergo HSCT_Article_BBMT.pdf

accesso aperto

Tipo: Versione (PDF) editoriale
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione - Non commerciale - Non opere derivate (CCBYNCND)
Dimensione 1.24 MB
Formato Adobe PDF
1.24 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/697391
Citazioni
  • ???jsp.display-item.citation.pmc??? 19
  • Scopus 54
  • ???jsp.display-item.citation.isi??? 43
social impact