Bowel wall thickness is a strong predictor of steroid-refractory acute graft-versus-host disease with gut involvement after allo-HSCT

• Published in: International journal of hematology Vol. 115; no. 4; pp. 545 - 552
• Main Authors: Drokov, Mikhail, Yatsyk, Galina, Kireeva, Anna, Pirikova, Olga, Dubnyak, Darya, Kuzmina, Larisa, Vasilyeva, Vera, Popova, Natalia, Starikova, Olga, Parovichnikova, Elena, Savchenko, Valeriy
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.04.2022; Springer Nature B.V
• Subjects: Acute Disease; Colon; Graft vs Host Disease - diagnostic imaging; Graft vs Host Disease - etiology; Graft vs Host Disease - therapy; Graft-versus-host reaction; Hematologic Neoplasms - therapy; Hematology; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Humans; Intestine; Medicine; Medicine & Public Health; Oncology; Original Article; Prospective Studies; Stem cell transplantation; Steroid hormones; Steroids; Steroids - therapeutic use; Thermal resistance; Thickness; Ultrasonic imaging; Gut aGVHD; Steroid refractory GVHD; Ultrasonography
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-021-03283-8

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.