Prophylactic Low-dose Heparin or Prostaglandin E1 may Prevent Severe Veno-occlusive Disease of the Liver after Allogeneic Hematopoietic Stem Cell Transplantation in Korean Children.
10.3346/jkms.2006.21.5.897
- Author:
Joon Sup SONG
1
;
Jong Jin SEO
;
Hyung Nam MOON
;
Thad GHIM
;
Ho Joon IM
Author Information
1. Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. hojim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Hepatic Veno-occlusive Disease;
Heparin;
Prostaglandins;
prevention and control;
Prophylaxis;
Hematopoietic Stem Cell Transplantation;
Child
- MeSH:
Risk Factors;
Male;
Infant;
Humans;
Hepatic Veno-Occlusive Disease/etiology/mortality/*prevention & control;
Heparin/*therapeutic use;
Hematopoietic Stem Cell Transplantation/*adverse effects;
Female;
Child, Preschool;
Child;
Alprostadil/*therapeutic use;
Adult;
Adolescent
- From:Journal of Korean Medical Science
2006;21(5):897-903
- CountryRepublic of Korea
- Language:English
-
Abstract:
Studies investigating the effect of prophylactic drugs on hepatic veno-occlusive disease (VOD) development are rare in children that have undergone allogeneic hematopoietic stem cell transplantation (HSCT). This study examined risk factors for VOD, the effect of prophylactic low-dose heparin or lipo-prostaglandin E1 (lipo-PGE1) and the survival rate at day +100 in children undergoing allogeneic HSCT. Eighty five children underwent HSCT between June 1997 and September 2004. Patients were diagnosed and classified as having mild, moderate or severe VOD according to Seattle clinical criteria. Among 85 patients, 25 (29%) developed VOD. VOD occurred more frequently in patients receiving busulfan-based conditioning (24/65, 37%) than in those receiving TBI-based (1/10, 10%) or other (0/10, 0%) regimens (p<0.05). The incidence of VOD was lower in patients with non-malignant disease compared to those with malignant disease (p<0.05). Survival at day +100 for non-VOD patients was better than that for VOD patients (92% vs. 76%, p<0.05). No patients receiving prophylactic heparin or lipo-PGE1 were found to develop severe VOD, whereas 5 of 35 patients not receiving such prophylaxis developed severe VOD. Given severe VOD is associated with a high mortality rate, this study indicates that prophylactic heparin or lipo-PGE1 may decrease mortality in children undergoing HSCT.
