Ultrasound in Hepatic Veno-occlusive Disease (HVOD) after Pediatric Hematopoietic Stem Cell Transplantation (HSCT): Comparison of Diagnostic Criteria Including the Pediatric Criteria of European Society for Blood and Marrow Transplantation (EBMT)

Pediatr Hematol Oncol. 2020 May;37(4):275-287. doi: 10.1080/08880018.2020.1725199. Epub 2020 Mar 5.

Abstract

The European Society for Blood and Marrow Transplantation (EBMT) has recently announced new diagnostic criteria for pediatric hepatic veno-occlusive disease (HVOD) after hematopoietic stem cell transplantation (HSCT). We retrospectively inspected 97 ultrasound exams of 60 pediatric HSCT patients, and compared its diagnostic value using the Baltimore, Seattle and pediatric EBMT criteria. Nine of the ten patients who were diagnosed as HVOD only in the EBMT criteria had severe or very severe HVOD. In the Seattle and EBMT criteria, portal vein velocity, peak systolic velocity and resistance index of hepatic artery, gallbladder wall thickening and ascites were statistically significant. No ultrasound variable showed significant association in the Baltimore criteria. All patients with portal vein velocity below 10 cm/s were in higher EBMT grade. A scoring system was developed, to evaluate the overall relationship of the ultrasound findings with the diagnosis of HVOD, showing fair (0.768 and 0.733) AUC in the ROC curve of EBMT and Seattle criteria.

Keywords: European Society for Blood and Marrow Transplantation (EBMT); Hepatic Veno-occlusive Disease (HVOD); Pediatric Hematopoietic Stem Cell Transplantation (HSCT).

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Europe
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hepatic Veno-Occlusive Disease* / diagnosis
  • Hepatic Veno-Occlusive Disease* / diagnostic imaging
  • Hepatic Veno-Occlusive Disease* / etiology
  • Hepatic Veno-Occlusive Disease* / physiopathology
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Societies, Medical
  • Ultrasonography