Pretransplantation liver function impacts on the outcome of allogeneic hematopoietic stem cell transplantation: A study of 455 patients

Pere Barba, José Luis Piñana, Francesc Fernández-Avilés, Jose Antonio Perez-Simón, Rodrigo Martino, Eva López-Guerrero, David Valcárcel, Montserrat Rovira, Silvana Novelli, Isabel Campos-Varela, Lucía López-Anglada, Xavier Vidal, Lucía López Corral, Enric Carreras, Jorge Sierra

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14 Citations (Scopus)

Abstract

Liver dysfunction is frequent before allogeneic stem cell transplantation (allo-SCT). However, its characteristics and impact on transplantation outcomes are uncertain, especially in the reduced-intensity conditioning (RIC) setting. We analyzed 455 patients receiving an allo-SCT in 3 Spanish centers. Pretransplantation aspartate aminotransferase (AST), alanine aminotransaminase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (AP), total bilirubin, and international normalized ratio were analyzed. Pretransplantation liver function test abnormalities were found in 94 (22%) patients. The most frequent cause of pretransplantation liver dysfunction was isolated elevation of GGT/AP (n = 49, 53%). Patients with high bilirubin levels before allo-SCT showed higher 4-year nonrelapse mortality (4y-NRM) (hazard ratio [HR] 2 [95% confidence interval [CI] 1.1-3.8] P = .02) and patients with high GGT levels showed higher 100-day NRM and lower 4-year overall survival (OS) (HR 3.4 [95% CI 1.8-6.7] P < .001, and HR 2 [95% CI 1.4-3], P = .001), respectively. High levels of transaminases did not influence on survival or mortality. In conclusion, hepatic dysfunction before allo-SCT is frequent and has an impact on transplantation outcomes. The best indicator of liver dysfunction still has to be determined. © 2011 American Society for Blood and Marrow Transplantation.
Original languageEnglish
Pages (from-to)1653-1661
JournalBiology of Blood and Marrow Transplantation
Volume17
DOIs
Publication statusPublished - 1 Nov 2011

Keywords

  • GGT
  • HCT-CI
  • Hepatic
  • Liver function
  • RIC
  • Reduced-intensity conditioning
  • Stem cell transplantation

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