Potential factors for and the prognostic impact of ascites after allogeneic hematopoietic stem cell transplantation

Sci Rep. 2023 Aug 10;13(1):13005. doi: 10.1038/s41598-023-39604-6.

Abstract

Ascites is sometimes detected after allogeneic hematopoietic stem cell transplantation (allo-HSCT); however, since limited information is currently available, its clinical meaning remains unclear. Therefore, we herein examined potential factors for and the impact of ascites on the prognosis of patients after allo-HSCT at our institutes. Fifty-eight patients developed ascites within 90 days of allo-HSCT (small in 34 (16%), moderate-large in 24 (11%)). A multivariate analysis identified veno-occlusive disease/sinusoidal obstruction syndrome (p = 0.01) and myeloablative conditioning (p = 0.01) as significant potential factors for the development of small ascites. Thrombotic microangiopathy (TMA) (p < 0.01) was a significant potential factor for moderate-large ascites. The incidence of both small and moderate-large ascites correlated with lower overall survival (p = 0.03 for small ascites and p < 0.01 for moderate-large ascites) and higher non-relapse mortality rates (p = 0.03 for small ascites and p < 0.01 for moderate-large ascites). Lower OS and higher NRM rates correlated with the incidence of both small and moderate-large ascites. Further investigation is warranted to establish whether the clinical sign of ascites improves the diagnostic quality of TMA in a large-scale study.

MeSH terms

  • Ascites / complications
  • Graft vs Host Disease* / diagnosis
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Thrombotic Microangiopathies* / diagnosis
  • Thrombotic Microangiopathies* / epidemiology
  • Thrombotic Microangiopathies* / etiology
  • Transplantation Conditioning / adverse effects