Characteristics of fiver enzyme abnormalities in acute graft-versus-host disease after bone marrow transplantation
10.3760/cma.j.issn.0578-1426.2010.05.010
- VernacularTitle:骨髓移植术后急性移植物抗宿主病肝酶学的异常特点
- Author:
Xiaodong MO
;
Lanping XU
;
Kaiyan LIU
;
Daihong LIU
;
Huan CHEN
;
Fengrong WANG
;
Xiaohui ZHANG
;
Wei HAN
;
Yuhong CHEN
;
Xiaojun HUANG
- Publication Type:Journal Article
- Keywords:
Hematopeietic stem cell transplantation;
Graft-versus-host disease;
Liver enzymology
- From:
Chinese Journal of Internal Medicine
2010;49(5):400-404
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the characteristics of liver enzyme between acute graft-versushost disease (aGVHD) and non-aGVHD groups after allogeneic hematopoietie stem cell transplantation (allo-HSCT). Methods The liver enzyme data of patients with or without aGVHD was analyzed. Results Among the 371 patients, 158 developed aGVHD(41.6%) with a median time of 29. 5 d. In non-aGVHD group, the median elevating times of ALT, AST, GGT, LDH were all ≤ 20 d after transplantation, which were significantly earlier than those of aGVHD group. The peak value of AST was much higher in aGVHD group, but the remaining liver enzyme showed no significant difference. In aGVHD group, the duration of AST, GGT and LDH was significantly longer than the non-occurrence of aGVHD group, but ALT and ALP showed no difference in duration. In ALT, AST, ALP and LDH elevating group, the occurrence rate of aGVHD was significantly higher, but only ALT and LDH elevation could enter logistic regression model. The sensitivity and veracity of ALT or LDH elevating only were not very good for the diagnosis of aGVHD, but if ALT and LDH beth elevated after day 24 and persisted more than 22 d, the sensitivity and veracity were better. Conclusions The change of liver enzyme is common in allo-HSCT and associates with the occurrence of aGVHD, and the liver enzyme elevating only may not be a good diagnostic index of aGVHD. If the dynamic characteristics of liver enzyme is taken into account and the effect of drug-induced liver injury could be excluded, the elevation of liver enzyme still have the diagnostic value of aGVHD.
