Risk factors for hepatic veno-occlusive disease: a retrospective unicentric study in 116 children autografted after a high-dose BU-thiotepa regimen.
At our Institute, during the last decade, the incidence of hepatic veno-occlusive disease (HVOD) appears to be on the increase among pediatric patients treated with BU-thiotepa (BU-TTP)-conditioning regimen. We thus performed a retrospective analysis to identify the risk factors for HVOD, which could explain such a change. In total, 116 patients treated at Institut Gustave Roussy, between May 1998 and December 2005 were eligible for this study having received BU-TTP as their first high-dose chemotherapy regimen, followed by autologous hematopoietic SCT (AHSCT). According to McDonald's clinical criteria, HVOD was diagnosed in 31% of these children. Demographic, clinical, biological and therapeutic parameters were evaluated in uni- and multivariate analyses that showed a significant correlation between previous carboplatin therapy and risk of developing post transplant HVOD (P=0.028). Comparable results were found for etoposide (P=0.048). In addition, a correlation between HVOD and risk of post transplant death was linked to its association with other types of organ failure (P=0.029). This study demonstrates that previous VPCARBO administration in conventional chemotherapy significantly increases the risk of HVOD among brain tumor patients later consolidated with BU-TTP followed by AHSCT.
Cacchione
A
A
Department of Pediatrics, Institut Gustave Roussy, Villejuif, France. antonellacacchione@katamail.com
LeMaitre
A
A
Couanet
D Valteau
DV
Benhamou
E
E
Amoroso
L
L
Simonnard
N
N
Hartmann
O
O
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy / Q000601:surgery*; D002066:Busulfan / Q000009:adverse effects*; D016190:Carboplatin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002998:Clonazepam / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012509:Sarcoma / Q000188:drug therapy / Q000601:surgery*; D012640:Seizures / Q000139:chemically induced / Q000517:prevention & control; D013852:Thiotepa / Q000009:adverse effects*; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014182:Transplantation, Autologous; D055815:Young Adult
D000970:Antineoplastic Agents; D002998:Clonazepam; D005047:Etoposide; D013852:Thiotepa; D016190:Carboplatin; D002066:Busulfan