Veno-occlusive Disease of the Liver after Blood and Marrow Transplantation: Analysis of Pre- and Post-transplant Risk Factors Associated with Severity and Results of Therapy with Tissue Plasminogen Activator
| Autor: | Peter M. Anderson, David Schembri-Wismayer, Dennis A. Gastineau, Pierre Noel, David J. Inwards, Kenneth P. Batts, Ayalew Tefferi, Louis Letendre, Martha Q. Lacy, M G Chen, Panagiotis Repoussis, H. Clark Hoagland, Mark R. Litzow, Georgene Schroeder, Lawrence A. Solberg, Carola A.S. Arndt, Morie A. Gertz |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Hepatic veno-occlusive disease Adolescent Bilirubin Hepatic Veno-Occlusive Disease Severity of Illness Index Tissue plasminogen activator Gastroenterology chemistry.chemical_compound Liver Function Tests Risk Factors Internal medicine Severity of illness medicine Humans Urea Bone Marrow Transplantation Retrospective Studies Peripheral Blood Stem Cell Transplantation medicine.diagnostic_test business.industry Marrow transplantation Retrospective cohort study Hematology Middle Aged Prognosis medicine.disease Surgery surgical procedures operative Oncology chemistry Tissue Plasminogen Activator Female Veno-Occlusive Disease business Liver function tests medicine.drug |
| Zdroj: | Leukemia & Lymphoma. 43:2099-2107 |
| ISSN: | 1029-2403 1042-8194 |
| DOI: | 10.1080/1042819021000032962 |
| Popis: | We reviewed our blood and marrow transplantation (BMT) database from April 1982 to July 1996 and identified 111 of 474 patients with serum bilirubin concentration (SBR)or = 34 micromol/l for two consecutive days within the first 20 days after related allogeneic or autologous BMT. Of the 111, 73 fulfilled the Seattle criteria for veno-occlusive disease of the liver (VOD) and had no other obvious cause for liver dysfunction. The patients were 16-60 years old (median, 39 years), and 41 were male (56%). Fourteen patients (19%) had autologous BMT, and 59 (81%) had allogeneic BMT. Twenty-eight (38%), 12 (16%), and 33 (45%) patients had severe, moderate, and mild VOD, respectively, by Seattle criteria. None of 23 patients with maximum (max) SBRor = 257 micromol/l survived, all patients with max SBRor = 128 micromol/l survived, and 7 of 15 patients (47%) with max SBR 128-257 micromol/l survived. The only pre-transplantation risk factor predictive of severe VOD was advanced disease state (P = 0.035), and the only transplant factors that predicted severe VOD were max SBR (P = 0.01) and maximum blood urea level (P = 0.03). Ten patients (all with creatinine levelsor = 150 micromol/l) were treated with tissue plasminogen activator; only two had a significant response and only one survived beyond day 120. |
| Databáze: | OpenAIRE |
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