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Transplant Toxicities

Focal nodular hyperplasia of the liver: an emerging complication of hematopoietic SCT in children

Bone Marrow Transplantation volume 50, pages 414–419 (2015)Cite this article

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Abstract

Hepatic focal nodular hyperplasia (FNH) is a nonmalignant condition rarely affecting children previously treated for cancer, especially those who received hematopoietic SCT (HSCT). Some aspects of its pathogenesis still remain unclear and a strong association with specific risk factors has not yet been identified. We report here a single institution's case series of 17 patients who underwent HSCT and were diagnosed with FNH, analyzing retrospectively their clinical features and the radiological appearance of their hepatic lesions. We aimed to compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) and to explore the role of transient elastography (FibroScan) to evaluate the degree of hepatic fibrosis in FNH patients. Our analysis showed an association of FNH with age at transplant ⩽12 years (hazard ratio (HR) 9.10); chronic GVHD (HR 2.99); hormone-replacement therapy (HR 4.02) and abdominal radiotherapy (HR 4.37). MRI proved to be a more accurate diagnostic tool compared with US. Nine out of 12 patients who underwent FibroScan showed hepatic fibrosis. Our study points out that FNH is an emerging complication of HSCT, which requires a lifelong surveillance to follow its course in cancer patients.

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Author notes

  1. M Pillon and N S Carucci: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Women’s and Children’s Health, Clinic of Pediatric Hemato-Oncology, University Hospital of Padova, Padova, Italy

    M Pillon, N S Carucci, C Mainardi, E Carraro, E Calore, M Tumino, S Varotto, R Destro, M V Gazzola, G Basso & C Messina

  2. Department of Radiology, University Hospital of Padova, Padova, Italy

    M Zuliani & T Toffolutti

  3. Medicine Department-DIMED, University Hospital of Padova, Padova, Italy

    L Chemello

  4. Pathology University of Padova, Padova, Italy

    R Alaggio

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  1. M Pillon
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Correspondence to C Messina.

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Pillon, M., Carucci, N., Mainardi, C. et al. Focal nodular hyperplasia of the liver: an emerging complication of hematopoietic SCT in children. Bone Marrow Transplant 50, 414–419 (2015). https://doi.org/10.1038/bmt.2014.276

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  • DOI: https://doi.org/10.1038/bmt.2014.276

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