Mikhail Drokov1,2, Galina Yatsyk3, Anna Kireeva3, Olga Pirikova3, Darya Dubnyak4, Larisa Kuzmina5,6, Vera Vasilyeva5,4, Natalia Popova5,6, Olga Starikova4, Elena Parovichnikova5, Valeriy Savchenko5. 1. Immunotherapy and Post-BMT Complications Department, National Research Center for Hematology, Novyy Zykovskiy Proezd, d. 4, 125167, Moscow, Russian Federation. mdrokov@gmail.com. 2. Bone Marrow Transplant Department, National Research Center for Hematology, Moscow, Russian Federation. mdrokov@gmail.com. 3. MRI and Ultrasonography Department, National Research Center for Hematology, Moscow, Russian Federation. 4. Immunochemotherapy Department for Patients After BMT, National Research Center for Hematology, Moscow, Russian Federation. 5. Immunotherapy and Post-BMT Complications Department, National Research Center for Hematology, Novyy Zykovskiy Proezd, d. 4, 125167, Moscow, Russian Federation. 6. Bone Marrow Transplant Department, National Research Center for Hematology, Moscow, Russian Federation.
Abstract
OBJECTIVE: Acute graft-versus-host-disease (aGVHD) develops in 10-80% of allo-HSCT patients. More than half of all aGVHD cases are refractory to first-line therapy with steroids. We hypothesized that bowel wall thickness at the time of aGVHD diagnosis could be an early sign of steroid-refractory aGVHD with gut involvement. METHOD: Our prospective study included 85 patients with hematological malignancies who had undergone allo-HSCT. We used an inexpensive, widespread and simple method of transabdominal ultrasonography to examine bowel wall thickness in patients suspected to have gut aGVHD. RESULTS: Descending colon wall thickness was significantly greater in patients with gut aGVHD later found to be steroid-refractory than in patients with steroid-sensitive gut aGVHD, with AUC-0.73 (95% CI 0.58-0.87, p = 0.013). We showed that bowel wall thickness could predict the steroid-refractoriness of aGVHD. CONCLUSION: Transabdominal ultrasonography could be used as a marker of steroid-refractory aGVHD with gut involvement after allo-HSCT.
OBJECTIVE: Acute graft-versus-host-disease (aGVHD) develops in 10-80% of allo-HSCT patients. More than half of all aGVHD cases are refractory to first-line therapy with steroids. We hypothesized that bowel wall thickness at the time of aGVHD diagnosis could be an early sign of steroid-refractory aGVHD with gut involvement. METHOD: Our prospective study included 85 patients with hematological malignancies who had undergone allo-HSCT. We used an inexpensive, widespread and simple method of transabdominal ultrasonography to examine bowel wall thickness in patients suspected to have gut aGVHD. RESULTS: Descending colon wall thickness was significantly greater in patients with gut aGVHD later found to be steroid-refractory than in patients with steroid-sensitive gut aGVHD, with AUC-0.73 (95% CI 0.58-0.87, p = 0.013). We showed that bowel wall thickness could predict the steroid-refractoriness of aGVHD. CONCLUSION: Transabdominal ultrasonography could be used as a marker of steroid-refractory aGVHD with gut involvement after allo-HSCT.