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Hematopoietic Stem Cell Transplantation / Liver Disease Diagnosis and Treatment / Liver Diseases and Immunity · Journal article
Hematology Reports · September 10, 2026
Early or partial results. Treat as a signal, not a conclusion.
This single-centre case series of 18 allo-HSCT recipients with pre-transplant steatotic liver disease reports that the condition did not preclude transplantation and was not associated with veno-occlusive disease, but documents high relapse rates (44%) and frequent transaminitis (89% by year 1). The findings are descriptive and hypothesis-generating rather than conclusive, and lack a comparator group to assess whether steatotic liver disease independently influenced outcomes.
Single-centre retrospective case series. Allogeneic HSCT recipients with bone marrow origin neoplasms and pre-transplant steatotic liver disease (18 patients identified from 306 screened at the centre). Intervention: Allogeneic hematopoietic stem cell transplantation in patients with pre-existing steatotic liver disease. n = 18. Single centre (location not specified).
18 of 306 screened patients (5.8%) had steatotic liver disease detected on pre-transplant non-contrast CT Post-transplant relapse occurred in 8 patients (44%) Relapses accounted for 78% and infections for 55% of deaths in the cohort
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While the authors conclude that steatotic liver disease is not a contraindication to allo-HSCT, this case series provides no evidence of causation or comparison to transplant outcomes in patients without steatotic liver disease. Clinicians should not alter transplant candidacy decisions based on this finding alone; the high relapse and transaminitis rates warrant investigation of potential mechanisms but do not yet establish steatotic liver disease as an independent prognostic factor.
Single-centre case series of 18 patients with descriptive outcomes and no comparator; generates mechanistic hypotheses about steatotic liver disease in allo-HSCT but lacks the control group and sample size needed to establish clinical impact.
As stated by the source record.
Quoted from the source exactly as published.
While the authors conclude that steatotic liver disease is not a contraindication to allo-HSCT, this case series provides no evidence of causation or comparison to transplant outcomes in patients without steatotic liver disease. Clinicians should not alter transplant candidacy decisions based on this finding alone; the high relapse and transaminitis rates warrant investigation of potential mechanisms but do not yet establish steatotic liver disease as an independent prognostic factor.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background/Objectives: Obesity and inflammatory conditions, including steatotic liver disease, are known to impact the hematopoietic niche and immune surveillance. Therefore, assessing the impact of steatotic liver disease on recipients of allogeneic stem cell transplantation (allo-HSCT) with bone marrow origin neoplasms is clinically relevant and an underexplored area of investigation. Methods: We followed the clinical course of allo-HSCT recipient patients with steatotic liver. Results: From 2014 to 2020 at our center, we identified 18 patients (5.8% of 306 patients screened) with steatotic liver disease detected on non-contrast CT imaging pre-transplant. With a minimum of 5 years follow-up for all, eight patients experienced post-transplant relapses (44%). Relapses (78%) followed by infections (55%) were the major contributors of mortality in this cohort. Pre-transplant transaminases were normal (AST median 28, ALT median 37) in all, while most patients (89%; 16/18) developed abnormal transaminases in the first-year post-transplantation without evidence of permanent liver injury. None experienced veno-occlusive disease of the liver. The cumulative incidence of acute graft-versus-host disease (aGVHD) was 33% (6/18), with 55% (10/18) experiencing chronic graft-versus-host disease (cGVHD). Conclusions: Our descriptive study highlights that radiologically detected steatotic liver disease is not a contraindication to proceeding with allogeneic stem cell transplant, and its association with transaminitis, relapse, immune complications, and post-transplant metabolic health requires future mechanistic studies.
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