P0812 ELEVATED SERUM TRYSPSINOGEN AMONG CHILDHOOD ALLOGENEIC HEMATOPOETIC STEM CELL TRANSPLANT RECIPIENTS: AN INDICATOR OF POOR OUTCOME?
Bibliographic record
Abstract
Introduction: Diarrhea, malabsorption and malnutrition are commonly encountered follow hematopoetic stem cell transplantation (HSCT). We had previously reported 4 cases of pancreatic insufficiency following allogeneic HSCT in children. Prospective data of the frequency of pancreatitis and pancreatic dysfunction in children undergoing HSCT have not been reported. Methods: A prospective, single centre study of all children undergoing a HSCT over a one year period (2001–2). Serial serum trypsinogen values were followed at 0, 1, 6 and 12 months (normal range 16.6–46.5 ng/mL) following HSCT. A high trypsinogen is suggestive of pancreatic inflammation, while a value of <7 ng/ml suggests exocrine pancreatic insufficiency. Aim: To determine the frequency of subclinical pancreatitis, its natural history, and its relationship to outcome in HSCT. Results: 52 of 62 eligible HSCT recipients (mean age 7.2 years) were recruited. Among these, 34/52 (65%) patients enrolled received an allogeneic HSCT (23 from matched unrelated donor). Prospective clinical data regarding diagnosis, treatment, and complications before and up to one year following HSCT were collected. 19/34 (56%) of allogeneic recipients had an elevated serum trypsinogen >50ng/ml at 1 and /or 6 months compared to only 2/18 (11%) of autologous HSCT recipients. Overall mortality at 1 year was 23.1% (allogeneic 26.4%, autologous 11.1%). Among allogeneic recipients with an elevated trypsinogen level, 47.4% died prior to 1 year of follow-up, as compared to 17.6% of those allogeneic HSCT recipients with normal trypsinogen levels (OR=5.1, 95% CI 1.1–23.3). 6/25 1 year survivors of allogeneic HSCT had persistently elevated trypsinogen levels. No case of pancreatic insufficiency was observed up to 1 year’s follow-up. Conclusion: Elevated serum trypsinogen, which probably reflects subclinical pancreatic inflammation, occurs more commonly in allogeneic transplant recipients. These results suggest that elevated serum trypsinogen is associated with a significant increase in mortality following allogeneic HSCT. Further analysis of the data will determine whether an association with acute graft-versus host disease (GVHD) exists. Follow up of this cohort will ascertain whether persistently elevated trypsinogen levels in transplant survivors, is a risk factor for the development of exocrine pancreatic failure subsequently.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".