Risk factors for hepatic veno-occlusive disease after bone marrow transplantation: retrospective analysis of 137 cases at a single institution.
One hundred and thirty-seven consecutive patients who received bone marrow or peripheral blood stem cell transplantation were studied retrospectively to identify the risk factors for hepatic veno-occlusive disease (VOD). Of the 137 recipients, twenty (14.6%) patients were diagnosed with VOD using the McDonald's criteria. In these 20 patients with VOD, we analyzed various clinical parameters, including age, sex, HLA status, conditioning regimen, irradiation, immunosuppressive agents, mode of transplantation, history of hepatic dysfunction, pre-transplant hepatic and renal function, infectious episodes, antibiotics use, and serum viral titers. A history of hepatic dysfunction and low levels of pseudocholinesterase before transplantation were found to be statistically significant (P = 0.04 and 0.04). Low levels of pseudocholinesterase were significant by multivariate analysis using the logistic regression model (P = 0.02). These results suggest that pseudocholinesterase levels before transplant are important markers of VOD in patients receiving BMT.
Kami
M
M
Tokyo Metropolitan Komagome Hospital, Japan.
Mori
S
S
Tanikawa
S
S
Akiyama
H
H
Onozawa
Y
Y
Tanaka
T
T
Okamoto
R
R
Maeda
Y
Y
Sasaki
T
T
Kaku
H
H
Matsuura
Y
Y
Hiruma
K
K
Sakamaki
H
H
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006504:Hepatic Veno-Occlusive Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007239:Infections / Q000382:microbiology / Q000473:pathology / Q000821:virology; D008099:Liver / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D019172:Transplantation Conditioning
D000900:Anti-Bacterial Agents; D006680:HLA Antigens; D007166:Immunosuppressive Agents