Steatotic Liver Disease in Allogeneic Hematopoietic Stem Cell Transplant Recipients: A Case Series and Literature Review.

Authors

Karthik Chetlapalli, Clifford Shin, Stuart Seropian, Francine Foss, Iris Isufi, Sarah Perreault, Manoj Pillai, Amer Zeidan, Mahan Mathur, Noffar Bar, Charles Kenworthy, Gary Israel, Lohith Gowda

Published in

Hematology reports. Volume 18. Issue 5. Sep 10, 2026. Epub Sep 10, 2026.

Abstract

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.

PMID:
42776831
Bibliographic data and abstract were imported from PubMed on 24 Sep 2026.

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