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With traditional therapies, patients with relapsed or refractory (R\/R) ALL have a survival that may be measured in months; in these patients, inotuzumab ozogamicin (IO) is an effective therapy. IO was linked to increased risk of veno\u2010occlusive disease\/sinusoid obstruction syndrome (VOD\/SOS), liver injury, and various grade of liver\u2010related complications during clinical trials and real\u2010life settings; however, hepatologic monitoring protocol is not established in this population. In our institution, 21 patients who received IO (median of 6 doses of IO administered) for R\/R ALL were prospectively followed for hepatologic surveillance, including clinical evaluation, ultrasonography, and liver stiffness measurement (LSM) biochemistry. After a median follow\u2010up of 17.2\u00a0months, two SOS events were reported (both after allogeneic transplant) as IO potentially related clinically relevant adverse event. Mild alterations were reported in almost the totality of patients and moderate\u2010severe liver biochemical alterations in a quarter of patients. Within biochemicals value, AST and ALP showed an augment related to IO administration. LSM linearly augmented for each IO course administered. Baseline LSM was related to liver\u2010related changes, especially with the severity of portal hypertension (PH)\u2010related complications. Pre\u2010transplant LSM was higher in patients receiving IO when compared with a control cohort. PH\u2010related complications were discovered in nearly 77% of patients, with clinically significant PH occurrence and development of ascites in 38% and 14%, respectively. This prospective experience constitutes the rationale to design a hepatologic monitoring program in patients receiving IO. LSM may be of pivotal importance in this program, constituting a rapid and effective screening that quantitatively correlates with liver alterations.<\/jats:p>","DOI":"10.1002\/cam4.4390","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T06:55:04Z","timestamp":1640933704000},"page":"618-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Assessment of liver stiffness measurement and ultrasound findings change during inotuzumab ozogamicin cycles for relapsed or refractory acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1142-8585","authenticated-orcid":false,"given":"Federico","family":"Ravaioli","sequence":"first","affiliation":[{"name":"IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Dipartimento di Scienze Mediche e Chirurgiche (DIMEC) Universit\u00e0 di Bologna  Bologna 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