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Predicting hepatic complications of allogeneic hematopoietic stem cell transplantation using liver stiffness measurement

Bone Marrow Transplantation volume 54, pages 1738–1746 (2019)Cite this article

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A Correction to this article was published on 19 March 2019

This article has been updated

Abstract

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.

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Data availability

For original data, please thomas.karlas@medizin.uni-leipzig.de.

Change history

  • 14 March 2019

    The original version of this Article was updated to correct some affiliations that were presented incorrectly. David Petroff is in fact the only author at affiliation 2. All other authors listed as being at affiliation 2 (Tina Weiße, Sebastian Beer, Franziska Gnatzy, Joachim Mössner, Michael Tröltzsch, Johannes Wiegand and Volker Keim) are in fact just at affiliation 1. These have now been corrected in the original article.

  • 19 March 2019

    In the original article, the affiliations were presented incorrectly. David Petroff is in fact the only author at affiliation 2. All other authors listed as being at affiliation 2 (Tina Weiße, Sebastian Beer, Franziska Gnatzy, Joachim Mössner, Michael Tröltzsch, Johannes Wiegand and Volker Keim) are in fact just at affiliation 1. These have now been corrected in the original article.

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Acknowledgements

Tina Weiße was supported by a student’s grant of the Medical Faculty of Leipzig University. We thank Katrin Moritz and Sabrina Fohler (Ultrasound and Endoscopy Unit, Leipzig University Hospital) for organizing the study examinations.

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Author notes

  1. These authors contributed equally: Thomas Karlas, Tina Weiße

Authors and Affiliations

  1. Division of Gastroenterology, University Hospital Leipzig, Leipzig, Germany

    Thomas Karlas, Tina Weiße, Sebastian Beer, Franziska Gnatzy, Joachim Mössner, Michael Tröltzsch, Johannes Wiegand & Volker Keim

  2. Clinical Trial Centre, University of Leipzig, Leipzig, Germany

    David Petroff

  3. Division of Hematology and Oncology, University Hospital Leipzig, Leipzig, Germany

    Christine Döhring, Dietger Niederwieser, Gerhard Behre & Georg-Nikolaus Franke

  4. Division of Gastroenterology, Section of Hepatology, University Hospital Leipzig, Leipzig, Germany

    Janett Fischer

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Contributions

TK, TW, and VK designed the study, performed the examinations, analyzed the data, and wrote the manuscript. DP analyzed the data and wrote the manuscript. SB, CD, FL, MT, and JW performed the examinations, analyzed the data, and revised the manuscript. DN, GB, and JM treated the patients, reviewed the study examinations, and revised the manuscript. JF performed the genetic analysis and revised the manuscript. G-NF designed the study, performed the examinations, analyzed the data, and wrote the manuscript. All authors had access to the primary clinical trial data.

Corresponding author

Correspondence to Thomas Karlas.

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Conflict of interest

TK, DP, and JW received unrestricted research grants from Echosens, France, not related to the study. TK and VK served as speakers for Siemens Health Care. G-NF received research grants and consulting fees from Jazz Pharmaceuticals, (Palo Alto, USA), Pfizer GmbH (Berlin, Germany), and Novartis Pharma GmbH (Nuremberg, Germany). All the remaining authors declare that they have no conflict of interest.

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Karlas, T., Weiße, T., Petroff, D. et al. Predicting hepatic complications of allogeneic hematopoietic stem cell transplantation using liver stiffness measurement. Bone Marrow Transplant 54, 1738–1746 (2019). https://doi.org/10.1038/s41409-019-0464-x

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