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P.-E. Debureaux et al.
not have a biopsy, the final diagnosis relied on a retrospec- tive analysis of all medical data, of clinical evolution with treatments, and on consensual diagnosis criteria if avail- able. However, the lack of gold standard criteria for most of diagnoses, such as GvHD, SOS or DILI, could bias con- clusions as there is currently no reliable tool to avoid mis- diagnoses. An unreliable TE or 2D-SWE value is classically estimated to be included between 5% and 10%, a range very similar to what was observed in our cohort.41 Using an intention to diagnose approach helped us to estimate the suitability of the liver stiffness measurement in addi- tion to clinical criteria for SOS diagnosis. Our results con- firm the interest of liver stiffness measures and strongly suggest that 2D-SWE significantly improved the positive predictive value of clinical scores for SOS diagnosis after allo-HSCT. Increasing the positive predictive value of cur- rent criteria for SOS is critical to avoid useless and poten- tially toxic treatment in patient with comorbidities.
Thus, 2D-SWE appears as a promising, non-invasive, quantitative, safe, and reproducible technique allowing an
early and accurate diagnosis of SOS. 2D-SWE measures combined with classical scores such as Baltimore or EBMT criteria could significantly help discriminating SOS from other post-transplantation early liver injury. Prospective multi-center trials would be necessary to confirm these results and to broadly evaluate the impact of liver stiffness measures on management and treatment of liver involve- ments after allo-HSCT.
Disclosures
No conflicts of interest to disclose.
Contributions
PED and DM collected, analyzed data and performed statis- tics analysis; PB, AMZ and MDB performed ultrasonography, Doppler and elastrography measurements; PER, SP, ASG, MR, RPL, AP, FSF, AX, PHP and DV provided data and commented manuscript; PED, GS and DM wrote the manuscript; GS and DM conceived the project and supervised the work; all authors approved the manuscript.
References
1. Gooley TA, Chien JW, Pergam SA, et al. Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med 2010;363(22):2091-2101.
2. McDonald GB. Hepatobiliary complica- tions of hematopoietic cell transplantation, 40 years On. Hepatology 2010;51(4):1450- 1460.
3. Gooley TA, Rajvanshi P, Schoch HG, McDonald GB. Serum bilirubin levels and mortality after myeloablative allogeneic hematopoietic cell transplantation. Hepatology 2005;41(2):345-352.
4. Hogan WJ. Hepatic injury after nonmye- loablative conditioning followed by allo- geneic hematopoietic cell transplantation: a study of 193 patients. Blood 2004; 103(1):78-84.
5.Ruggiu M, Bedossa P, Rautou PE, et al. Utility and safety of liver biopsy in patients with undetermined liver blood test anom- alies after allogeneic hematopoietic stem cell transplantation: a monocentric retro- spective cohort study. Biol Blood Marrow Transplant 2018;24(12):2523-2531.
6. Lassau N, Leclère J, Auperin A, et al. Hepatic veno-occlusive disease after mye- loablative treatment and bone marrow transplantation: value of gray-scale and Doppler US in 100 patients. Radiology 1997;204(2):545-552.
7. Nishida M, Kahata K, Hayase E, et al. Novel Ultrasonographic scoring system of sinusoidal obstruction syndrome after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant J Am Soc Blood Marrow Transplant 2018; 24(9):1896-1900.
8. EASL Clinical Practice Guidelines: vascular diseases of the liver. J Hepatol 2016; 64(1):179-202.
9. Teefey SA, Brink JA, Borson RA, Middleton WD. Diagnosis of venoocclusive disease of the liver after bone marrow transplanta- tion: value of duplex sonography. AJR Am J Roentgenol 1995;164(6):1397-1401.
10. McCarville MB, Hoffer FA, Howard SC, Goloubeva O, Kauffman WM. Hepatic veno-occlusive disease in children undergo- ing bone-marrow transplantation: useful- ness of sonographic findings. Pediatr Radiol
2001;31(2):102-105.
11. Shiina T, Nightingale KR, Palmeri ML, et al.
WFUMB guidelines and recommendations for clinical use of ultrasound elastography: part 1: basic principles and terminology. Ultrasound Med Biol 2015;41(5):1126- 1147.
12. European Association for Study of Liver, Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH Clinical Practice Guidelines: non-invasive tests for evalua- tion of liver disease severity and prognosis. J Hepatol 2015;63(1):237-264.
13. Dietrich CF, Trenker C, Fontanilla T, et al. New ultrasound techniques challenge the diagnosis of sinusoidal obstruction syn- drome. Ultrasound Med Biol 2018; 44(11):2171-2182.
14.Bacigalupo A, Ballen K, Rizzo D, et al. Defining the intensity of conditioning regi- mens: working definitions. Biol Blood Marrow Transplant J Am Soc Blood Marrow Transplant 2009;15(12):1628-1633.
15. Armand P, Gibson CJ, Cutler C, et al. A dis- ease risk index for patients undergoing allo- geneic stem cell transplantation. Blood 2012;120(4):905-913.
16. Dietrich CF, Bamber J, Berzigotti A, et al. EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elas- tography, update 2017 (long version). Ultraschall Med Stuttg Ger 1980 2017; 38(4):e16-e47.
17. Glucksberg H, Storb R, Fefer A, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation 1974;18(4):295-304.
18. McDonald GB, Hinds MS, Fisher LD, et al. Veno-occlusive disease of the liver and multiorgan failure after bone marrow trans- plantation: a cohort study of 355 patients. Ann Intern Med 1993;118(4):255-267.
19. Jones RJ, Lee KS, Beschorner WE, et al. Venoocclusive disease of the liver following bone marrow transplantation. Transplantation 1987;44(6):778-783.
20. Mohty M, Malard F, Abecassis M, et al. Revised diagnosis and severity criteria for sinusoidal obstruction syndrome/veno- occlusive disease in adult patients: a new classification from the European Society for Blood and Marrow Transplantation. Bone
Marrow Transplant 2016;51(7):906-912.
21. Cohen JF, Korevaar DA, Altman DG, et al. STARD 2015 guidelines for reporting diag- nostic accuracy studies: explanation and elaboration. BMJ Open 2016; 6(11):
e012799.
22. Andrade RJ, Aithal GP, Björnsson ES, et al.
EASL clinical practice guidelines: drug- induced liver injury. J Hepatol 2019; 70(6):1222-1261.
23. Schuetz GM, Schlattmann P, Dewey M. Use of 3x2 tables with an intention to diag- nose approach to assess clinical perform- ance of diagnostic tests: meta-analytical evaluation of coronary CT angiography studies. BMJ 2012;345e6717.
24. McDonald GB, Sharma P, Matthews DE, Shulman HM, Thomas ED. Venocclusive disease of the liver after bone marrow transplantation: diagnosis, incidence, and predisposing factors. Hepatol Baltim Md 1984;4(1):116-122.
25. Schuetz GM, Schlattmann P, Dewey M. Use of 3×2 tables with an intention to diag- nose approach to assess clinical perform- ance of diagnostic tests: meta-analytical evaluation of coronary CT angiography studies. BMJ;345.
26. Sakai M, Strasser SI, Shulman HM, McDonald SJ, Schoch HG, McDonald GB. Severe hepatocellular injury after hematopoietic cell transplant: incidence, etiology, and outcome. Bone Marrow Transplant 2009;44(7):441-447.
27. Dighe M, Bruce M. Elastography of diffuse liver diseases. Semin Roentgenol 2016; 51(4):358-366.
28. Roulot D, Czernichow S, Le Clésiau H, Costes J-L, Vergnaud A-C, Beaugrand M. Liver stiffness values in apparently healthy subjects: influence of gender and metabolic syndrome. J Hepatol 2008;48(4):606-613.
29. Petzold G, Hofer J, Ellenrieder V, Neesse A, Kunsch S. Liver stiffness measured by 2- dimensional shear wave elastography: prospective evaluation of healthy volun- teers and patients with liver cirrhosis. J Ultrasound Med Off J Am Inst Ultrasound Med 2019;38(7):1769-1777.
30. Auberger J, Graziadei I, Clausen J, Vogel W, Nachbaur D. Non-invasive transient elas- tography for the prediction of liver toxicity following hematopoietic SCT. Bone
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