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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03426358
Other study ID # ELASTOVOD
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date April 28, 2015
Est. completion date December 2021

Study information

Verified date April 2022
Source IRCCS Azienda Ospedaliero-Universitaria di Bologna
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

ELASTOVOD is a prospective multicenter study, involving several centers of Onco-haematology in Italy. Investigators perform hepatic elastographic measurements (with Transient Elastography, ARFI or 2D-SWE) on patients undergoing HSCT, at baseline before transplantation (T0) and at T1/T2/T3 after HSCT (+9/10, +15/17, +22/24). SOS/VOD diagnosis was performed according to clinical criteria.


Description:

Sinusoidal Obstruction Syndrome (SOS), also known as hepatic Veno-Occlusive Disease (VOD), is a life-threatening complication in patients undergoing Hematopoietic Stem Cells Transplantation (HSCT) for onco-haematological disease. In the severe form, mortality rate can be high as 80%. Patients developing SOS/VOD present a higher survival rate when earlier SOS/VOD- specific therapy has initiated. In order to get better outcomes, it is necessary to improve early diagnosis of SOS/VOD, finding new non--invasive diagnostic instruments. The aim of this prospective multicenter study is to assess in a large, mixed (adult and paediatric) population undergoing HSCT, the diagnostic role for SOS/VOS of Liver Stiffness Measurement (LSM), assessed by different elastographic methods. In our study, Liver Stiffness Measurement (LSM) can be measured by Transient Elastography (TE) with Fibroscan, Acoustic Radiation Force Impulse (ARFI) or 2D-Share Wave Elastography (2D-SWE). Once chosen an elastometric method at baseline, the same must be used for all subsequent evaluations of the patient. In patients undergoing HSCT, within one month, a complete baseline evaluation is provided. Baseline evaluation (T0) includes: signature of informed consent, haematological and hepatological anamnesis, in order to assess comorbidities and risk factors for hepato-biliary complications; complete laboratory tests; abdominal Color-Doppler Ultrasound and hepatic Elastography (with Transient Elastography, ARFI or 2D-SWE). After conditioning and HSCT, each patient is evaluated at T1 (+9/10), T2 (+15/17), T3 (+22/24) with: bedside Elastography, laboratory tests, clinical examination based on clinical criteria for SOS/VOD diagnosis (e.g. Baltimora criteria, modified Seattle criteria, new EBMT criteria). RUCAM-CIOMS Scale can be assess, in order to establish DILI (Drug Induced Liver Injury) diagnosis, as well. In case of SOS/VOD suspicion, patient goes through an intense monitoring period: laboratory tests, clinical evaluation for SOS/VOD diagnosis, Color-Doppler US and Elastography are repeatedly performed in next days. This monitoring period stops if diagnosis of SOS/VOD or other diagnosis is reached. Each center will prospectively collect data according to an electronic e-CFR on REDCap (Research Electronic Data Capture) system, a web application designed to support data capture for research studies in a secure manner.


Recruitment information / eligibility

Status Completed
Enrollment 1101
Est. completion date December 2021
Est. primary completion date December 2021
Accepts healthy volunteers No
Gender All
Age group 3 Years to 70 Years
Eligibility Inclusion Criteria: - male or female patients - age between 3 and 70 - patients suffering from an onco-hematological disease that have an indication for either allogenic or autologous hematopoietic stem cells transplantation - obtaining of informed consent Exclusion Criteria: - pathological obesity (BMI >40) - pacemaker of implantable defibrillator - presence of ascites at baseline

Study Design


Related Conditions & MeSH terms


Intervention

Device:
LSM assessed by Elastographic Techniques
Performing Transient Elastography, ARFI or 2D-SWE on patients at baseline (within 1 month before HSCT) and after HSCT on days +9/10, +15/17, +22/24

Locations

Country Name City State
Italy Azienda Ospedaliera-Nazionale SS. Antonio e Biagio e Cesare Arrigo Alessandria
Italy Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona Ancona
Italy Azienda Ospedaliero-Universitaria Consorziale - Policlinico di Bari Bari
Italy ASST Papa Giovanni XXIII Ospedali riuniti di Bergamo Bergamo
Italy Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi. Bologna BO
Italy Azienda Sanitaria dell'Alto Adige Bolzano
Italy Spedali Civili di Brescia, UO Ematologia Brescia
Italy Policlinico Vittorio Emanuele - Presidio Ferrarotto Catania
Italy Azienda Ospedaliera-Universitaria Careggi Firenze
Italy Azienda Ospedaliera-Universitaria Meyer Firenze
Italy Ospedale Policlinico San Martino Genova
Italy Ospedale Vito Fazzi Lecce
Italy Ospedale dell'Angelo Mestre
Italy ASST Grande Ospedale Metropolitano Niguarda Milano
Italy Ospedale Maggiore Policlinico di Milano Milano
Italy Ospedale San Raffaele Milano
Italy Azienda Ospedaliera-Universitaria di Modena Modena
Italy Ospedale Pediatrico Pausilipon Napoli
Italy Policlinico Federico II Napoli
Italy Azienda Ospedaliero-Universitaria di Padova Padova
Italy Azienda Ospedaliera Ospedali riuniti Villa Sofia- Cervello Palermo
Italy Azienda Ospedaliero-Universitaria Ospedale Maggiore di Parma Parma
Italy Azienda Sanitaria Locale di Pescara Pescara
Italy Azienda Ospedaliero-universitaria Pisana, UO Ematologia Pisa
Italy Azienda Ospedaliero-Universitaria Pisana, UO Oncoematologia Pediatrica Pisa
Italy Arcispedale S. Maria Nuova di Reggio Emilia Reggio Emilia
Italy Ospedale Pediatrico Bambino Gesù Roma
Italy Policlinico Tor Vergata Roma
Italy Policlinico Umberto I - Università la Sapienza Roma RM
Italy Policlinico Universitario A. Gemelli Roma
Italy Istituto Clinico Humanitas Rozzano Milano
Italy Casa Sollievo della Sofferenza San Giovanni Rotondo Foggia
Italy Azienda Ospedaliero-Universitaria Città della Salute e della Scienza Torino
Italy Azienda Ospedaliera "Card. G. Panico" Tricase Lecce
Italy Azienda Ospedaliero-Universitaria Integrata di Udine Udine
Italy Azienda Ospedaliero-Universitaria Integrata di Verona Verona
Italy Azienda Ospedaliera di Vicenza Vicenza

Sponsors (1)

Lead Sponsor Collaborator
IRCCS Azienda Ospedaliero-Universitaria di Bologna

Country where clinical trial is conducted

Italy, 

References & Publications (25)

Auberger J, Graziadei I, Clausen J, Vogel W, Nachbaur D. Non-invasive transient elastography for the prediction of liver toxicity following hematopoietic SCT. Bone Marrow Transplant. 2013 Jan;48(1):159-60. doi: 10.1038/bmt.2012.113. Epub 2012 Jun 18. — View Citation

Bamber J, Cosgrove D, Dietrich CF, Fromageau J, Bojunga J, Calliada F, Cantisani V, Correas JM, D'Onofrio M, Drakonaki EE, Fink M, Friedrich-Rust M, Gilja OH, Havre RF, Jenssen C, Klauser AS, Ohlinger R, Saftoiu A, Schaefer F, Sporea I, Piscaglia F. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall Med. 2013 Apr;34(2):169-84. doi: 10.1055/s-0033-1335205. Epub 2013 Apr 4. — View Citation

Berzigotti A, Castera L. Update on ultrasound imaging of liver fibrosis. J Hepatol. 2013 Jul;59(1):180-2. doi: 10.1016/j.jhep.2012.12.028. Epub 2013 Jan 15. Review. — View Citation

Bota S, Herkner H, Sporea I, Salzl P, Sirli R, Neghina AM, Peck-Radosavljevic M. Meta-analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis. Liver Int. 2013 Sep;33(8):1138-47. doi: 10.1111/liv.12240. Epub 2013 Jul 16. Review. — View Citation

Bureau C, Metivier S, Peron JM, Selves J, Robic MA, Gourraud PA, Rouquet O, Dupuis E, Alric L, Vinel JP. Transient elastography accurately predicts presence of significant portal hypertension in patients with chronic liver disease. Aliment Pharmacol Ther. 2008 Jun;27(12):1261-8. doi: 10.1111/j.1365-2036.2008.03701.x. Epub 2008 Apr 4. — View Citation

Carreras E, Díaz-Beyá M, Rosiñol L, Martínez C, Fernández-Avilés F, Rovira M. The incidence of veno-occlusive disease following allogeneic hematopoietic stem cell transplantation has diminished and the outcome improved over the last decade. Biol Blood Marrow Transplant. 2011 Nov;17(11):1713-20. doi: 10.1016/j.bbmt.2011.06.006. Epub 2011 Jun 25. — View Citation

Colecchia A, Marasco G, Ravaioli F, Kleinschmidt K, Masetti R, Prete A, Pession A, Festi D. Usefulness of liver stiffness measurement in predicting hepatic veno-occlusive disease development in patients who undergo HSCT. Bone Marrow Transplant. 2017 Mar;52(3):494-497. doi: 10.1038/bmt.2016.320. Epub 2016 Dec 12. — View Citation

Corbacioglu S, Carreras E, Ansari M, Balduzzi A, Cesaro S, Dalle JH, Dignan F, Gibson B, Guengoer T, Gruhn B, Lankester A, Locatelli F, Pagliuca A, Peters C, Richardson PG, Schulz AS, Sedlacek P, Stein J, Sykora KW, Toporski J, Trigoso E, Vetteranta K, Wachowiak J, Wallhult E, Wynn R, Yaniv I, Yesilipek A, Mohty M, Bader P. Diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in pediatric patients: a new classification from the European society for blood and marrow transplantation. Bone Marrow Transplant. 2018 Feb;53(2):138-145. doi: 10.1038/bmt.2017.161. Epub 2017 Jul 31. — View Citation

del Campo L, León NG, Palacios DC, Lagana C, Tagarro D. Abdominal complications following hematopoietic stem cell transplantation. Radiographics. 2014 Mar-Apr;34(2):396-412. doi: 10.1148/rg.342135046. — View Citation

Dignan FL, Wynn RF, Hadzic N, Karani J, Quaglia A, Pagliuca A, Veys P, Potter MN; Haemato-oncology Task Force of British Committee for Standards in Haematology; British Society for Blood and Marrow Transplantation. BCSH/BSBMT guideline: diagnosis and management of veno-occlusive disease (sinusoidal obstruction syndrome) following haematopoietic stem cell transplantation. Br J Haematol. 2013 Nov;163(4):444-57. doi: 10.1111/bjh.12558. Epub 2013 Sep 17. — View Citation

Fontanilla T, Hernando CG, Claros JC, Bautista G, Minaya J, Del Carmen Vega M, Piazza A, Méndez S, Rodriguez C, Arangüena RP. Acoustic radiation force impulse elastography and contrast-enhanced sonography of sinusoidal obstructive syndrome (Veno-occlusive Disease): preliminary results. J Ultrasound Med. 2011 Nov;30(11):1593-8. — View Citation

Jones RJ, Lee KS, Beschorner WE, Vogel VG, Grochow LB, Braine HG, Vogelsang GB, Sensenbrenner LL, Santos GW, Saral R. Venoocclusive disease of the liver following bone marrow transplantation. Transplantation. 1987 Dec;44(6):778-83. — View Citation

Karlas T, Weber J, Nehring C, Kronenberger R, Tenckhoff H, Mössner J, Niederwieser D, Tröltzsch M, Lange T, Keim V. Value of liver elastography and abdominal ultrasound for detection of complications of allogeneic hemopoietic SCT. Bone Marrow Transplant. 2014 Jun;49(6):806-11. doi: 10.1038/bmt.2014.61. Epub 2014 Apr 7. — View Citation

Lassau N, Auperin A, Leclere J, Bennaceur A, Valteau-Couanet D, Hartmann O. Prognostic value of doppler-ultrasonography in hepatic veno-occlusive disease. Transplantation. 2002 Jul 15;74(1):60-6. — View Citation

Lassau N, Leclère J, Auperin A, Bourhis JH, Hartmann O, Valteau-Couanet D, Benhamou E, Bosq J, Ibrahim A, Girinski T, Pico JL, Roche A. Hepatic veno-occlusive disease after myeloablative treatment and bone marrow transplantation: value of gray-scale and Doppler US in 100 patients. Radiology. 1997 Aug;204(2):545-52. — View Citation

Lucena MI, García-Cortés M, Cueto R, Lopez-Duran J, Andrade RJ. Assessment of drug-induced liver injury in clinical practice. Fundam Clin Pharmacol. 2008 Apr;22(2):141-58. doi: 10.1111/j.1472-8206.2008.00566.x. Review. Erratum in: Fundam Clin Pharmacol. 2009 Feb;23(1):147. — View Citation

McDonald GB, Sharma P, Matthews DE, Shulman HM, Thomas ED. Venocclusive disease of the liver after bone marrow transplantation: diagnosis, incidence, and predisposing factors. Hepatology. 1984 Jan-Feb;4(1):116-22. — View Citation

McDonald GB. Hepatobiliary complications of hematopoietic cell transplantation, 40 years on. Hepatology. 2010 Apr;51(4):1450-60. doi: 10.1002/hep.23533. Review. — View Citation

Millonig G, Reimann FM, Friedrich S, Fonouni H, Mehrabi A, Büchler MW, Seitz HK, Mueller S. Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosis. Hepatology. 2008 Nov;48(5):1718-23. doi: 10.1002/hep.22577. — View Citation

Mohty M, Malard F, Abecassis M, Aerts E, Alaskar AS, Aljurf M, Arat M, Bader P, Baron F, Bazarbachi A, Blaise D, Ciceri F, Corbacioglu S, Dalle JH, Dignan F, Fukuda T, Huynh A, Masszi T, Michallet M, Nagler A, NiChonghaile M, Okamoto S, Pagliuca A, Peters C, Petersen FB, Richardson PG, Ruutu T, Savani BN, Wallhult E, Yakoub-Agha I, Duarte RF, Carreras E. Revised diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a new classification from the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant. 2016 Jul;51(7):906-12. doi: 10.1038/bmt.2016.130. Epub 2016 May 16. — View Citation

Mohty M, Malard F, Abecassis M, Aerts E, Alaskar AS, Aljurf M, Arat M, Bader P, Baron F, Bazarbachi A, Blaise D, Ciceri F, Corbacioglu S, Dalle JH, Duarte RF, Fukuda T, Huynh A, Masszi T, Michallet M, Nagler A, NiChonghaile M, Pagluica T, Peters C, Petersen FB, Richardson PG, Ruutu T, Savani BN, Wallhult E, Yakoub-Agha I, Carreras E. Sinusoidal obstruction syndrome/veno-occlusive disease: current situation and perspectives-a position statement from the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant. 2015 Jun;50(6):781-9. doi: 10.1038/bmt.2015.52. Epub 2015 Mar 23. Review. — View Citation

Richardson PG, Smith AR, Triplett BM, Kernan NA, Grupp SA, Antin JH, Lehmann L, Miloslavsky M, Hume R, Hannah AL, Nejadnik B, Soiffer RJ. Earlier defibrotide initiation post-diagnosis of veno-occlusive disease/sinusoidal obstruction syndrome improves Day +100 survival following haematopoietic stem cell transplantation. Br J Haematol. 2017 Jul;178(1):112-118. doi: 10.1111/bjh.14727. Epub 2017 Apr 26. — View Citation

Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, Christidis C, Ziol M, Poulet B, Kazemi F, Beaugrand M, Palau R. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol. 2003 Dec;29(12):1705-13. — View Citation

Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, Storer B. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005 Oct 15;106(8):2912-9. Epub 2005 Jun 30. — View Citation

Wadleigh M, Ho V, Momtaz P, Richardson P. Hepatic veno-occlusive disease: pathogenesis, diagnosis and treatment. Curr Opin Hematol. 2003 Nov;10(6):451-62. Review. — View Citation

* Note: There are 25 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Diagnostic Role of Liver Stiffness Measurement in SOS/VOD development To assess in a large, mixed (adult and paediatric) population undergoing HSCT, the role of Liver Stiffness Measurement (LSM), assessed by different elastographic methods, in SOS/VOD diagnosis. From HSCT to 30 days after HSCT
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