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Article: Hepatitic graft-versus-host disease after hematopoietic stem cell transplantation: Clinicopathologic features and prognostic implication

TitleHepatitic graft-versus-host disease after hematopoietic stem cell transplantation: Clinicopathologic features and prognostic implication
Authors
Issue Date2004
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
Citation
Transplantation, 2004, v. 77 n. 8, p. 1252-1259 How to Cite?
AbstractBackground. Graft-versus-host disease (GVHD) of the liver after allogeneic hematopoietic stem cell transplantation classically presents with increased bilirubin and alkaline phosphatase (ALP) levels. A hepatitic variant was recently recognized, with more than a 10-fold increase in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. This study defines the clinicopathologic features and prognostic implications of hepatitic GVHD compared with classic liver GVHD. Method. A total of 38 cases of hepatitic GVHD, 68 cases of classic liver GVHD, and 13 cases of hepatitis B virus (HBV)-related hepatitis after hematopoietic stem cell transplantation were analyzed. Results. Hepatitic GVHD cases showed significantly higher ALT, AST, and ALP levels compared with classic liver GVHD cases (at onset, mean ALT: 154 vs. 58 U/L, P<0.001; AST: 167 vs. 77 U/L, P<0.001; at peak, ALT: 435 vs. 112 U/L, P<0.001; AST: 587 vs. 150 U/L, P<0.001; ALP: 416 vs. 238 U/L, P=0.001), persisted longer (74 vs. 32 days, P=0.006), and showed more lobular pathologic changes in biopsy (lobular changes: 16/26 vs. 4/19, P=0.007; hepatocyte necrosis: 1(1/26 vs. 6/19, P=0.008; acidophil bodies: 15/26 vs. 4/19, P=0.014) but less cholestasis (426 vs. 8/19, P=0.045). However, cumulative doces of immminosuppressants prescribed, response, and outcome were similar. Compared with hepatitic GVHD, HBV-related hepatitis occurred later (95 vs. 184 days, P=0.04.9), but clinical and biochemical profiles were similar, requiring liver biopsies for their distinction. Conclusions. Hepatitic and classic liver GVHD differed biochemically and pathologically, but these differences showed no obvious impact on outcome. The distinction of hepatitic GVHD from other hepatitis is mandatory.
Persistent Identifierhttp://hdl.handle.net/10722/148421
ISSN
2015 Impact Factor: 3.69
2015 SCImago Journal Rankings: 1.699
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMa, SYen_HK
dc.contributor.authorAu, WYen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorLie, AKWen_HK
dc.contributor.authorLeung, AYHen_HK
dc.contributor.authorLiang, Ren_HK
dc.contributor.authorLau, GKKen_HK
dc.contributor.authorKwong, YLen_HK
dc.date.accessioned2012-05-29T06:12:52Z-
dc.date.available2012-05-29T06:12:52Z-
dc.date.issued2004en_HK
dc.identifier.citationTransplantation, 2004, v. 77 n. 8, p. 1252-1259en_HK
dc.identifier.issn0041-1337en_HK
dc.identifier.urihttp://hdl.handle.net/10722/148421-
dc.description.abstractBackground. Graft-versus-host disease (GVHD) of the liver after allogeneic hematopoietic stem cell transplantation classically presents with increased bilirubin and alkaline phosphatase (ALP) levels. A hepatitic variant was recently recognized, with more than a 10-fold increase in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. This study defines the clinicopathologic features and prognostic implications of hepatitic GVHD compared with classic liver GVHD. Method. A total of 38 cases of hepatitic GVHD, 68 cases of classic liver GVHD, and 13 cases of hepatitis B virus (HBV)-related hepatitis after hematopoietic stem cell transplantation were analyzed. Results. Hepatitic GVHD cases showed significantly higher ALT, AST, and ALP levels compared with classic liver GVHD cases (at onset, mean ALT: 154 vs. 58 U/L, P<0.001; AST: 167 vs. 77 U/L, P<0.001; at peak, ALT: 435 vs. 112 U/L, P<0.001; AST: 587 vs. 150 U/L, P<0.001; ALP: 416 vs. 238 U/L, P=0.001), persisted longer (74 vs. 32 days, P=0.006), and showed more lobular pathologic changes in biopsy (lobular changes: 16/26 vs. 4/19, P=0.007; hepatocyte necrosis: 1(1/26 vs. 6/19, P=0.008; acidophil bodies: 15/26 vs. 4/19, P=0.014) but less cholestasis (426 vs. 8/19, P=0.045). However, cumulative doces of immminosuppressants prescribed, response, and outcome were similar. Compared with hepatitic GVHD, HBV-related hepatitis occurred later (95 vs. 184 days, P=0.04.9), but clinical and biochemical profiles were similar, requiring liver biopsies for their distinction. Conclusions. Hepatitic and classic liver GVHD differed biochemically and pathologically, but these differences showed no obvious impact on outcome. The distinction of hepatitic GVHD from other hepatitis is mandatory.en_HK
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.comen_HK
dc.relation.ispartofTransplantationen_HK
dc.rightsTransplantation. Copyright © Lippincott Williams & Wilkins.-
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAlanine Transaminase - Blooden_US
dc.subject.meshAlkaline Phosphatase - Blooden_US
dc.subject.meshAspartate Aminotransferases - Blooden_US
dc.subject.meshBilirubin - Blooden_US
dc.subject.meshFemaleen_US
dc.subject.meshGraft Vs Host Disease - Drug Therapy - Etiology - Pathologyen_US
dc.subject.meshHematopoietic Stem Cell Transplantation - Adverse Effectsen_US
dc.subject.meshHepatitis - Drug Therapy - Etiology - Pathologyen_US
dc.subject.meshHepatitis B - Drug Therapy - Etiology - Pathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshLiver Diseases - Drug Therapy - Etiology - Pathologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPrognosisen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshTransplantation, Homologousen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleHepatitic graft-versus-host disease after hematopoietic stem cell transplantation: Clinicopathologic features and prognostic implicationen_HK
dc.typeArticleen_HK
dc.identifier.emailNg, IOL:iolng@hkucc.hku.hken_HK
dc.identifier.emailLeung, AYH:ayhleung@hku.hken_HK
dc.identifier.emailLiang, R:rliang@hku.hken_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityLeung, AYH=rp00265en_HK
dc.identifier.authorityLiang, R=rp00345en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid15114094-
dc.identifier.scopuseid_2-s2.0-2342450528en_HK
dc.identifier.hkuros87683-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-2342450528&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume77en_HK
dc.identifier.issue8en_HK
dc.identifier.spage1252en_HK
dc.identifier.epage1259en_HK
dc.identifier.isiWOS:000221130900022-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridMa, SY=7403725725en_HK
dc.identifier.scopusauthoridAu, WY=7202383089en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridLie, AKW=24284842400en_HK
dc.identifier.scopusauthoridLeung, AYH=7403012668en_HK
dc.identifier.scopusauthoridLiang, R=26643224900en_HK
dc.identifier.scopusauthoridLau, GKK=7102301257en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK

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