| Autor: |
M. M. Kanunnikov, J. Z. Rakhmanova, M. V. Barabanshikova, N. V. Levkovsky, A. I. Wafina, O. V. Paina, T. A. Bykova, Е. V. Semenova, О. V. Goloshapov, E. V. Morozova, I. S. Mоiseev, L. S. Zubarovskaya |
| Jazyk: |
ruština |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
Учёные записки Санкт-Петербургского государственного медицинского университета им. Акад. И.П. Павлова, Vol 27, Iss 4, Pp 62-70 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
1607-4181 |
| DOI: |
10.24884/1607-4181-2020-27-4-62-70 |
| Popis: |
Introduction. Sinusoidal obstructive syndrome (SOS)/veno-occlusive liver disease (VOD) is one of the most dangerous complication of allogeneic hematopoietic stem cell transplantation (alloHSCT).The objective of our study was to analyze risk factors associated with SOS/VOD in children and adults after alloHSCT.Methods and materials. The study included 76 patients who were diagnosed with the development of SOS/VOD after alloHSCT performed in Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation between 2001 and 2019. 25 patients (32.9 %) were younger than 18 years, 51 patients (68.1 %) — 18 years and older. Among them, 17 patients were treated with defibrotide at a dose of 25 mg/kg per day, median therapy duration — 21 day.Results. One-year overall survival (OS) was significantly higher when partial and complete response to the therapy was achieved — 45 %, than when there was no response — 0 % in the general group (p = 0.001). According to the results of multivariate analysis of unrelated alloHSCT HR 2.040 (95 %CI 1.112-3.744, р = 0.021), acute GVHD HR 0.496 (95 % CI 0.272-0.903, р = 0.022), moderate/severe SOS/VOD HR 2.423 (95 % CI 1.298-4.524, p = 0.005) statistically significantly influenced the 1-year OS. Defibrotide and accompanying therapy did not significantly influence the 1-year OS in children and adults (n=76) - 53 % and 54 % (p=0.86), respectively. In a multivariate analysis. unrelated alloHSCT HR 8.172 (95 %CI 2.176-30.696, р=0.002) and moderate and severe SOS/VOD HR 9.077 (95 % CI 2.425-33.978, р=0.001) significantly influenced the 1-year OS in the pediatric group.Conclusion. The understanding of risk factors of adverse prognosis in patients SOS/VOD facilitates selection of patients who will benefit the most from therapy with defibrotide. Early administration of defibrotide in the course of VOD/SOS is crucial to achieve response. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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