Results From a UK Consensus via Delphi on Practical Considerations Surrounding Risk Assessment and Patient Monitoring for a Prompt Diagnosis of Severe Veno-Occlusive Disease (VOD) in Adults Post-HSCT

Introduction

Veno-occlusive disease (VOD) is a life-threatening complication of haematopoietic stem cell transplantation (HSCT). The diagnosis remains challenging, with under recognition of the initial signs and symptoms potentially resulting in delayed diagnoses. The aim of this Delphi study is to establish a consensus regarding the optimal risk assessment and onward care of patients with VOD.

Methods

The process employed a modified Delphi methodology. A steering group of six VOD experts working in the United Kingdom attended a virtual meeting in September 2023, developed 44 statements for testing. Respondents were offered a four-point Likert scale to indicate their level of agreement with each statement.

Results

A total of 70 responses were received from healthcare providers working in the area of haematology and oncology in the United Kingdom. All statements achieved consensus. Overall, 82% of statements achieved ≥ 90% (n = 36/44), and 18% achieved ≥ 75% agreement (n = 8/44).

Conclusion

This modified Delphi process achieved consensus across all statements, allowing for a set of recommendations to be developed to support a consistent approach across the United Kingdom for the risk assessment and patient monitoring procedures for VOD post-HSCT.

Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.