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Risk factors for hepatic veno-occlusive disease following HLA-identical sibling bone marrow transplants for leukemia. Bone Marrow Transplant 1996 Jan;17(1):75-80 PMID: 8673059

Pubmed ID

8673059

Abstract

The objective was to analyze risk factors for veno-occlusive disease of the liver (VOD) after allogeneic bone marrow transplantation. A cohort of 1717 recipients of HLA-identical sibling transplants for leukemia between 1988 and 1990, in 200 transplant teams worldwide, was studied. Patients were scored as having VOD if liver tissue showed typical histologic features or if they had all three of the following: (1) jaundice; (2) hepatomegaly and right upper quadrant abdominal pain; and (3) ascites and/or unexplained weight gain. Patients surviving more than 7 days post-transplant without histologic or any of these clinical features of VOD were classified as not having VOD. Patient-, disease- and transplant-related characteristics of 95 patients with VOD were compared to those of 1514 without VOD. Variables correlated with an increased risk of VOD were: pretransplant conditioning with busulfan and cyclophosphamide compared to total body radiation (relative risk (RR) 2.8; P < 0.0001), pretransplant fungal infection (RR 4.1; P = 0.011), pretransplant Karnofsky performance score < 90% (RR 1.9; P = 0.012), prior liver disease (RR 1.9; P = 0.05) and age > 20 years (RR 1.8; P = 0.05). In patients receiving radiation for conditioning, intravenous immune globulin decreased VOD risk (RR 0.26; P = 0.003). This analysis identifies risk factors for VOD. The data suggest several strategies for modifying transplant regimens to reduce VOD risk and which patients might be suitable subjects for trials of strategies of VOD prevention.

Author List

Rozman C, Carreras E, Qian C, Gale RP, Bortin MM, Rowlings PA, Ash RC, Champlin RE, Henslee-Downey PJ, Herzig RH, Hinterberger W, Klein JP, Prentice HG, Reiffers J, Zwaan FE, Horowitz MM

Author

Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-13344250481   88 Citations

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Adult
Bone Marrow Transplantation
Child
Child, Preschool
Female
Graft vs Host Disease
Hepatic Veno-Occlusive Disease
Histocompatibility Testing
Humans
Infant
Leukemia
Male
Middle Aged
Risk Factors
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5