Liver disease during the first post-transplant year in bone marrow transplantation recipients: retrospective study

Abstract

Summary:Liver dysfunction is a common problem in BMT recipients and it is important to determine the etiology in order to institute appropriate therapy. The purpose of this study was to evaluate the possible causes of liver dysfunction during the first post-transplant year in BMT recipients and to identify a possible relationship between pre-existing liver dysfunction and viral hepatitis with prognosis after BMT. We reviewed liver status before and after BMT in 130 consecutive patients at the Catholic Hematopoietic Stem Cell Transplantation Center. Liver dysfunction during the first post-transplant year occurred in 85 out of 101 (84.2%) allogeneic BMT recipients and 13 out of 29 (44.8%) autologous BMT recipients. In allogeneic BMT, GVHD and drug hepatotoxicity were major causes. In autologous BMT, drug hepatotoxicity was the most common cause. Eighteen out of 130 patients (13.8%) had abnormal liver function tests before BMT. These patients did not have an increased risk of post-transplant liver dysfunction, GVHD, and death compared to patients who had normal liver function tests prior to BMT. Nine patients were hepatitis B antigen positive and three patients were anti-HCV positive prior to BMT. There was no significant increase in the incidence of post-transplant liver dysfunction, GVHD, and death in these patients. Bone Marrow Transplantation (2000) 26, 193-197.

Drug interactions and adverse events associated with antimycotic drugs used for invasive aspergillosis in hematopoietic SCT

“…17,19,[45][46][47] However, a retrospective evaluation of hepatic drug safety is limited, as hepatic dysfunction after allogeneic HSCT is common, occurring in 84% of patients, and may be because of a variety of causes such as GVHD, infections such as viral hepatitis, hepatic venoocclusive disease and/or recurrence of underlying disease. 48 Owing to the retrospective study design, ADEs affecting organs other than the liver or kidney were not assessed, as a systematic evaluation of patients could not be guaranteed. Transient visual disorders were frequently reported during voriconazole treatment in other studies, 27,28 but were not detected in our study.…”

Abnormal liver enzymes 2 years after haematopoietic stem cell transplantation in children: prevalence and risk factors

“…Abnormal liver enzymes in the early phase after transplant may be due to drug toxicity, bacterial or fungal infection, viral infection or reactivation, acute GVHD and veno-occlusive disease (VOD). [1][2][3][4][5] In children, only one study has been published on this subject, showing that 28% of children undergoing HSCT had transient hyperbilirubinaemia and 88% had transient elevation of aminotranferases during the early phase after transplant. 6 In some patients, elevated liver enzymes may persist or recur late after transplantation.…”

Hepatic graft-versus-host disease presenting as an acute hepatitis after allogeneic peripheral blood stem cell transplantation

“…There are many possible causes for liver disorders in the setting of allogeneic hematopoietic cell transplantation, especially in the early post-transplant phase. 1,2 In our case, the liver aminotransferases were markedly elevated, but the bilirubin, ALP and ␥-GTP levels showed only mild elevation. The differential diagnosis included hepatic veno-occlusive disease (VOD), viral infection, hepatic GVHD and drug toxicity.…”

“…She received one course of consolidation chemotherapy with VP-16 (100 mg/m 2 /day i.v. days [1][2][3][4][5] and Ara-C (500 mg/m 2 i.v. twice daily on days 1-6) with no liver enzyme abnormalities.…”

“…1,2 The hepatic manifestation of acute GVHD is characterized by cholestatic jaundice. In acute GVHD, an increased serum alkaline phosphatase (ALP) is usually followed by hyperbilirubinemia and mild hepatomegaly.…”