The researchers investigated a noninvasive method capable of predicting the severity of veno-occlusive disease (VOD) at the time of the diagnosis.
The findings of the study were published in the latest edition of Transplantation.
A total of 71 children who developed VOD after intensive myeloablative therapy with busulfan, before hematopoietic stem cell transplantation, were included in the study.
Of these, 64 patients underwent baseline ultrasonography (US) and Doppler examination before transplantation.
At the time of the clinical and biological diagnosis of VOD, all patients had post-transplantation Doppler examinations and US.
| Flow recorded in para-umbilical vein significantly associated with VOD grade.
| Transplantation |
The authors studied 7 US morphological criteria and 7 Doppler criteria. These yielded 3 individual scores: a US score, a Doppler score, and a total Doppler ultrasonography score.
In the univariate analysis, 3 of 7 US criteria, 3 of 7 Doppler criteria, and the 3 scores were correlated with the severity of VOD after transplantation, and at the time of the diagnosis.
In the multivariate analysis, 2 US criteria (splenomegaly and ascites) and 1 Doppler criterion (flow recorded in para-umbilical vein) were associated with the severity of VOD.
The investigators found that multivariate analysis of the pooled US and Doppler criteria showed that the flow recorded in the para-umbilical vein was the only criterion significantly associated with the grade of VOD.
All patients with a US-Doppler score above 9 developed grade 2 or 3 VOD.
Dr Nathalie Lassau, of Institut Gustave Roussy, Villejuif, concluded on behalf of fellow authors, "Postgraft US and Doppler examinations have a prognostic significance according to the grade of VOD."