Abstract
ABSTRACT
Background
Veno‐occlusive disease (VOD) is a common complication post‐hematopoietic stem cell transplant (HSCT) and is associated with increased mortality. Factors predictive of outcomes are lacking. Albumin–bilirubin (ALBI) score is used to quantify liver function and prognosticate but has not been investigated in VOD.
Methods
Single‐center retrospective study investigating the ALBI score in children aged 0–26 years who underwent HSCT from 2019 to 2024 and developed VOD. Primary outcome was hospital mortality. ALBI score was calculated at time points chosen a priori spanning preconditioning to post‐VOD diagnosis.
Results
Forty‐three patients developed VOD. Most were transplanted for cancer (
n
= 33, 77%). Seven (16%) died. Preconditioning median ALBI scores did not differ between survivors and non‐survivors. Median ALBI scores significantly increased from preconditioning −3.00 (IQR: −3.10, −2.80) to VOD diagnosis −1.70 (IQR: −2.00, −1.50),
p
p
= 0.008, AUC = 0.83). Using an established cutoff, severe ALBI on day 7 post‐VOD diagnosis had greater mortality odds (OR = 8.3 [95% CI: 1.4, 48.5],
p
= 0.02). Those who died trended toward higher ALBI 3 days prior to VOD diagnosis than those who survived, −1.70 (IQR: −1.90, −1.30) versus −2.10 (IQR: −2.40, −1.80),
p
= 0.16.
Conclusions
In this cohort, ALBI score worsened with VOD diagnosis and at 7 days post‐diagnosis was associated with mortality. The ALBI score is easily obtained and may aid in VOD prognostication.