Hepatomegaly is an extramedullary disease (EMD) manifestation of hematological malignancy. Although EMD before allogeneic hematopoietic stem cell transplantation (allo-HCT) is a risk factor for relapse in patients not in complete remission (NonCR) patients, the significance of hepatomegaly to allo-HCT is unclear. We conducted a single-center retrospective observational study of 140 patients with acute leukemia and myelodysplastic syndrome who underwent allo-HCT at our institution from 2014 to 2019. Hepatomegaly was assessed by ultrasonography using the liver index (LI). In the univariable analysis, the LI/height ratio was significantly associated with relapse (hazard ratio [HR] per standard deviation [sd]: 1.51, 95% confidence interval [CI] 1.18–1.93, p = 0.001, sd = 13.8) in NonCR patients (n = 62), but showed no significant association in CR patients (n = 78) (HR per sd: 0.95, 95% CI 0.64–1.39, p = 0.780, sd = 8.7). In multivariable analysis, the LI/height ratio was significantly associated with relapse (HR per sd: 1.34, 95% CI 1.02–1.78, p = 0.037) after adjusting for the refined disease risk index and conditioning intensity. Interaction analysis showed a noteworthy but not statistically significant association between the LI/height ratio and CR status (p = 0.110). In conclusion, our findings suggest that the LI may be a risk factor for relapse in NonCR patients after allo-HCT.

肝肿大是血液系统恶性肿瘤的髓外疾病（EMD）表现。尽管异基因造血干细胞移植（allo-HCT）前的EMD是未完全缓解（NonCR）患者复发的危险因素，但肝肿大对allo-HCT的意义尚不清楚。我们对 2014 年至 2019 年在我们机构接受异基因 HCT 的 140 名急性白血病和骨髓增生异常综合征患者进行了一项单中心回顾性观察研究。通过超声检查使用肝脏指数 (LI) 评估肝肿大。在单变量分析中，LI/身高比与复发显着相关（每标准差 [sd] 的风险比 [HR]：1.51，95% 置信区间 [CI] 1.18–1.93， p = 0.001，sd = 13.8）非 CR 患者 ( n = 62)，但与 CR 患者 ( n = 78) 没有显着相关性（HR per sd：0.95，95% CI 0.64–1.39， p = 0.780，sd = 8.7）。在多变量分析中，在调整精细的疾病风险指数和调理强度后，LI/身高比与复发显着相关（HR per sd：1.34，95% CI 1.02-1.78， p = 0.037）。交互分析显示 LI/身高比与 CR 状态之间存在值得注意但不具有统计学意义的关联 ( p = 0.110)。总之，我们的研究结果表明，LI 可能是非 CR 患者异基因 HCT 后复发的危险因素。