[Analysis of acute liver "graft-versus-host disease" following allogeneic myeloablative stem cell transplant]

The purpose of this study was to evaluate liver graft-versus-host disease (GVHD) after allogeneic myeloablative stem cell transplant (within day 100). We retrospectively reviewed the data on 61 patients with incidence of hepatic GVHD, the clinical course, laboratory data and histologic features of the liver biopsy. Between February 1998 and March 2002, 61 patients received an allogeneic myeloablative stem cell transplant. The diagnosis of liver dysfunction was based on marked (more than 3 times the upper normal limit) elevation of serum aminotransferases or on a level above 2 mg/dl of total bilirubin. We used criteria for grading (GVHD) on consensus conference. The diagnosis of hepatic "GVHD" was based on classical liver GVHD, on histological GVHD without jaundice or on elevation of serum aminotransferases with other GVHD. Liver function abnormality occurred in 50 out of 61 (82%). The main causes of hepatic dysfunction were hepatic "GVHD" (19 out of 50, 38%). Of the 19 hepatic "GVHD" patients, elevation of serum aminotransferases alone was seen in 13 patients (68%), jaundice alone was seen in 1 patient (5%) and both were seen in 5 patients (27%). The treatment with glucocorticoids was successful in those patients with elevation of serum aminotransferases alone.