[Characteristics of liver enzyme abnormalities in acute graft-versus-host disease after bone marrow transplantation].
OBJECTIVE
To investigate the characteristics of liver enzyme between acute graft-versus-host disease (aGVHD) and non-aGVHD groups after allogeneic hematopoietic 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 both 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.
Mo
Xiao-dong
XD
Institute of Hematology, People's Hospital, Peking University, Beijing 100044, China.
Xu
Lan-ping
LP
Liu
Kai-yan
KY
Liu
Dai-hong
DH
Chen
Huan
H
Wang
Feng-rong
FR
Zhang
Xiao-hui
XH
Han
Wei
W
Chen
Yu-hong
YH
Huang
Xiao-jun
XJ
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000201:enzymology*; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult