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Retrospective study finds pre-transplant hepatomegaly, measured by the liver index (LI)/height ratio, to be a potential predictor of relapse in not-in-complete remission (NonCR) patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HCT).

The following is a summary of “Pretransplant hepatomegaly is linked to relapse in patients with leukemia and myelodysplastic syndrome not in remission,” published in the January 2024 issue of Hematology by Okayama et al.

Researchers conducted a retrospective study to clarify the impact of pre-transplant hepatomegaly, an extramedullary disease (EMD) marker in not-in-complete remission (NonCR) patients, on outcomes of allogeneic hematopoietic stem cell transplantation (allo-HCT).

They performed a single-center study involving 140 patients with acute leukemia and myelodysplastic syndrome who underwent allo-HCT (2014 to 2019). Hepatomegaly was evaluated through ultrasonography, utilizing the liver index (LI).

The results showed univariable analysis; the LI/height ratio exhibited a significant connection with relapse (HR per sd: 1.51, 95% CI 1.18–1.93, P=0.001, sd = 13.8) among NonCR patients (n = 62). However, it displayed no association in CR patients (n = 78) (HR per sd: 0.95, 95% CI 0.64–1.39, P=0.780, sd = 8.7). In the multivariable analysis, the LI/height ratio retained a significant association with relapse (HR per sd: 1.34, 95% CI 1.02–1.78, P=0.037) after adjusting for the refined disease risk index and conditioning intensity. The analysis found a notable yet nonsignificant association between the LI/height ratio and CR status (P=0.110).

Investigators concluded that pre-transplant LI, a marker of EMD in NonCR patients, emerged as a potential predictor of relapse after allo-HCT.

Source: link.springer.com/article/10.1007/s12185-023-03707-7