Hepatic veno-occlusive disease (VOD) with complete occlusion of liver venules after tandem autologous stem cell transplantation-- successful treatment with high-dose methylprednisolone and defibrotide.
Veno-occlusive disease (VOD) is a life-threatening complication following allogeneic or autologous stem cell transplantation. We report on a patient with a high grade B-cell lymphoma who presented 28 days after the second autologous stem cell transplantation with weight gain, ascites, hyperbilirubinemia, and liver venules occlusion as demonstrated by sonography. Starting with high-dose methylprednisolone treatment followed by defibrotide maintenance therapy the patient showed dramatic complete response of VOD, resulting in a normal sonography of the liver and normalization of laboratory values. The response of the occlusion of nearly all liver venules underlines the value of anti-inflammatory treatment combined with new thrombolytic medication such as defibrotide for the treatment of severe VOD.
Sayer
H G
HG
Klinik und Poliklinik für Innere Medizin II (Hämatologie, Onkologie, Endokrinologie und Stoffwechselerkrankungen) der Friedrich-Schiller-Universität Jena, Erlanger Allee 101, 07740 Jena, Germany. Herbert.Sayer@med.uni-jena.de
Will
U
U
Schilling
K
K
Vogt
T
T
Wollina
K
K
Höffken
K
K
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006504:Hepatic Veno-Occlusive Disease / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D016393:Lymphoma, B-Cell / Q000628:therapy*; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology*; D016896:Treatment Outcome; D014463:Ultrasonography
D000893:Anti-Inflammatory Agents; D005343:Fibrinolytic Agents; D008775:Methylprednisolone