[Prevention of hepatic veno-occlusive disease by a combination of heparin and prostaglandin E1 in children undergoing hematopoietic stem cell transplantation].
The effect and safety of combination prophylaxis for hepatic veno-occlusive disease (VOD) following stem cell transplantation (SCT) was retrospectively evaluated in a total of 53 children who survived until day 30. Prophylaxis was started on the day before conditioning, and heparin (10 unit/kg/hr) alone was used in 6 patients, PGE1 (5 ng/kg/min) plus heparin plus PTX (200 mg/day) in 17 patients, lipo-PGE1 (0.5 ng/kg/min) plus heparin plus PTX in 7 patients, and lipo-PGE1 plus heparin in 23 patients. Diagnosis of VOD was made based on McDonald's criteria in 5 cases (9.4%), but not on Jones' criteria. No statistically significant difference was observed in the incidence of VOD among each prophylaxis group. The degree of VOD was mild in all of 5 cases, and all recovered with continuation of the prophylactic procedure. Each prophylactic procedure was performed without any significant adverse effect except for seizure induced by lipo-PGE1 in one patient with Lennox syndrome. Since both the incidence and fatality rate of VOD in children undergoing SCT are approximately 20% according to most of the previous reports, the present study suggests the effectiveness of combination prophylaxis.
Inukai
Takeshi
T
Department of Pediatrics, Faculty of Medicine, University of Yamanashi.
Sugita
Kanji
K
Goi
Kumiko
K
Akahane
Koshi
K
Hirose
Kinuko
K
Nemoto
Atsushi
A
Takahashi
Kazuya
K
Sato
Hiroki
H
Uno
Kanako
K
Furuichi
Yoshiyuki
Y
Nakamura
Makoto
M
Miyamoto
Naohiko
N
Yamakawa
Naoko
N
Shiraishi
Kyoko
K
Kojika
Satoru
S
Tezuka
Toru
T
Iijima
Kiyomu
K
Nakazawa
Shinpei
S
D000293:Adolescent; D000527:Alprostadil / Q000008:administration & dosage*; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006493:Heparin / Q000008:administration & dosage*; D006504:Hepatic Veno-Occlusive Disease / Q000517:prevention & control*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies
D006493:Heparin; D000527:Alprostadil