 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 February 1993 | Volume 118 Issue 4 | Pages 255-267
Objective: To determine the incidence and clinical course of veno-occlusive disease of the liver (VOD) after bone marrow transplantation and to analyze risk factors for severe VOD.
Design: Cohort study of 355 consecutive patients.
Setting: A bone marrow transplantation center.
Measurements: Each patient was prospectively evaluated for VOD, and many risk factors for severe VOD were analyzed using logistic regression models. The relation of VOD to renal and cardiopulmonary failure was analyzed using time-dependent proportional hazards models.
Results: Veno-occlusive disease developed in 190 of 355 patients (54%; 95% CI, 48% to 59%): Fifty-four patients had severe VOD and 136 had mild or moderate VOD. Independent variables derived from a multivariate model for predicting severe VOD included elevated transaminase values before transplantation (relative risk, 4.6; P < 0.0001); vancomycin therapy during cytoreductive therapy (relative risk, 2.9; P = 0.003); cytoreductive therapy with a high-dose regimen (relative risk, 2.8; P = 0.01); acyclovir therapy before transplantation (relative risk, 4.8; P = 0.02); mismatched or unrelated donor marrow (relative risk, 2.4; P = 0.02); and previous radiation therapy to the abdomen (relative risk, 2.2; P = 0.04). Vancomycin therapy was a marker for persistent fever. Multiorgan failure was more frequent among patients with VOD and usually followed the onset of liver disease.
Conclusions: Veno-occlusive disease, which developed in 54% of bone marrow transplant recipients, is frequently associated with renal and cardiopulmonary failure. Pretransplant transaminase elevations, use of high-dose cytoreductive therapy, and persistent fever during cytoreductive therapy are independent predictors of severe VOD.
Author and Article Information
From the Fred Hutchinson Cancer Research Center and the University of Washington School of Medicine, Seattle, Washington.
ARTICLE
Veno-occlusive Disease of the Liver and Multiorgan Failure after Bone Marrow Transplantation: A Cohort Study of 355 Patients
Acknowledgments: The authors thank Bruce Ballard, Fred Drennan, Finn Peterson, and Scott Bearman for their assistance; and to Michelle Tesler, Jami Martin, Lok Lee, and Doris Martin for their help with data entry.
Grant Support: In part by grants CA18029 and CA15704 from the National Institutes of Health Public Health Service and by grants from the Bristol-Myers Company and the Carl Inserra Leukemia Fund.
This article has been cited by other articles:
|
|
 |
|
  R. Aplenc, T. A. Alonzo, R. B. Gerbing, B. J. Lange, C. A. Hurwitz, R. J. Wells, I. Bernstein, P. Buckley, K. Krimmel, F. O. Smith, et al. Safety and Efficacy of Gemtuzumab Ozogamicin in Combination With Chemotherapy for Pediatric Acute Myeloid Leukemia: A Report From The Children's Oncology Group J. Clin. Oncol., May 10, 2008; 26(14): 2390 - 2395. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K.-H. Lee, S. S. Park, I. Kim, J. H. Kim, E. K. Ra, S.-S. Yoon, Y.-C. Hong, S. Park, and B. K. Kim P2X7 receptor polymorphism and clinical outcomes in HLA-matched sibling allogeneic hematopoietic stem cell transplantation Haematologica, May 1, 2007; 92(5): 651 - 657. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Levine, O. M. Navarro, G. Chaudry, J. J. Doyle, and S. I. Blaser Imaging the Complications of Bone Marrow Transplantation in Children RadioGraphics, March 1, 2007; 27(2): 307 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Bouligand, A. Deroussent, N. Simonnard, P. Opolon, J. Morizet, E. Connault, E. Daudigeos, M. Re, A. Paci, and G. Vassal Induction of Glutathione Synthesis Explains Pharmacodynamics of High-Dose Busulfan in Mice and Highlights Putative Mechanisms of Drug Interaction Drug Metab. Dispos., February 1, 2007; 35(2): 306 - 314. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. L. Dignan, D. Gujral, M. E. Ethell, J. Treleaven, G. Morgan, and M. Potter Prophylactic Defibrotide in Allogeneic Stem Cell Transplantation: Low Morbidity and Zero Mortality from Veno-Occlusive Disease. Blood (ASH Annual Meeting Abstracts), November 16, 2006; 108(11): 2968 - 2968. [Abstract] [PDF]
|
|
|
|
 |
|
 S. M. Erturk, K. J. Mortele, C. A. Binkert, J. N. Glickman, M.-R. Oliva, P. R. Ros, and S. G. Silverman CT features of hepatic venoocclusive disease and hepatic graft-versus-host disease in patients after hematopoietic stem cell transplantation. Am. J. Roentgenol., June 1, 2006; 186(6): 1497 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Parimon, D. H. Au, P. J. Martin, and J. W. Chien A risk score for mortality after allogeneic hematopoietic cell transplantation. Ann Intern Med, March 21, 2006; 144(6): 407 - 414. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Arceci, J. Sande, B. Lange, K. Shannon, J. Franklin, R. Hutchinson, T. A. Vik, D. Flowers, R. Aplenc, M. S. Berger, et al. Safety and efficacy of gemtuzumab ozogamicin in pediatric patients with advanced CD33+ acute myeloid leukemia Blood, August 15, 2005; 106(4): 1183 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. Schrier and C. R. Parikh Comparison of renal injury in myeloablative autologous, myeloablative allogeneic and non-myeloablative allogeneic haematopoietic cell transplantation Nephrol. Dial. Transplant., April 1, 2005; 20(4): 678 - 683. [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Humphreys, R. J. Soiffer, and C. C. Magee Renal Failure Associated with Cancer and Its Treatment: An Update J. Am. Soc. Nephrol., January 1, 2005; 16(1): 151 - 161. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Matsumoto, H. Wada, H. Nishiyama, T. Hirano, M. Sakakura, K. Nishii, M. Masuya, S. Kageyama, S. Tamaki, K. Nakase, et al. Hemostatic Abnormalities and Changes Following Bone Marrow Transplantation Clinical and Applied Thrombosis/Hemostasis, October 1, 2004; 10(4): 341 - 350. [Abstract] [PDF]
|
|
|
|
 |
|
 G.C. MacQuillan and D. Mutimer Fulminant liver failure due to severe veno-occlusive disease after haematopoietic cell transplantation: a depressing experience QJM, September 1, 2004; 97(9): 581 - 589. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Diaconescu, C. R. Flowers, B. Storer, M. L. Sorror, M. B. Maris, D. G. Maloney, B. M. Sandmaier, and R. Storb Morbidity and mortality with nonmyeloablative compared with myeloablative conditioning before hematopoietic cell transplantation from HLA-matched related donors Blood, September 1, 2004; 104(5): 1550 - 1558. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Sorror, M. B. Maris, B. Storer, B. M. Sandmaier, R. Diaconescu, C. Flowers, D. G. Maloney, and R. Storb Comparing morbidity and mortality of HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative and myeloablative conditioning: influence of pretransplantation comorbidities Blood, August 15, 2004; 104(4): 961 - 968. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Arndt, D. Hawkins, J.R. Anderson, P. Breitfeld, R. Womer, and W. Meyer Age Is a Risk Factor for Chemotherapy-Induced Hepatopathy With Vincristine, Dactinomycin, and Cyclophosphamide J. Clin. Oncol., May 15, 2004; 22(10): 1894 - 1901. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Qiu, T. F. Kalhorn, and J. T. Slattery ABCC2-Mediated Biliary Transport of 4-Glutathionylcyclophosphamide and Its Contribution to Elimination of 4-Hydroxycyclophosphamide in Rat J. Pharmacol. Exp. Ther., March 1, 2004; 308(3): 1204 - 1212. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Wingard, W. G. Nichols, and G. B. McDonald Supportive Care Hematology, January 1, 2004; 2004(1): 372 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Hogan, M. Maris, B. Storer, B. M. Sandmaier, D. G. Maloney, H. G. Schoch, A. E. Woolfrey, H. M. Shulman, R. Storb, and G. B. McDonald Hepatic injury after nonmyeloablative conditioning followed by allogeneic hematopoietic cell transplantation: a study of 193 patients Blood, January 1, 2004; 103(1): 78 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Ghersin, O. R. Brook, D. Gaitini, and A. Engel Color Doppler Demonstration of Segmental Portal Flow Reversal: An Early Sign of Hepatic Veno-occlusive Disease in an Infant J. Ultrasound Med., October 1, 2003; 22(10): 1103 - 1106. [Full Text] [PDF]
|
|
|
|
|
|
M. Wadleigh, P. G. Richardson, D. Zahrieh, S. J. Lee, C. Cutler, V. Ho, E. P. Alyea, J. H. Antin, R. M. Stone, R. J. Soiffer, et al. Prior gemtuzumab ozogamicin exposure significantly increases the risk of veno-occlusive disease in patients who undergo myeloablative allogeneic stem cell transplantation Blood, September 1, 2003; 102(5): 1578 - 1582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Bornhauser, B. Storer, J. T. Slattery, F. R. Appelbaum, H. J. Deeg, J. Hansen, P. J. Martin, G. B. McDonald, W. G. Nichols, J. Radich, et al. Conditioning with fludarabine and targeted busulfan for transplantation of allogeneic hematopoietic stem cells Blood, August 1, 2003; 102(3): 820 - 826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Cordonnier, S. Chevret, M. Legrand, H. Rafi, N. Dhedin, B. Lehmann, F. Bassompierre, E. Gluckman, and for the GREFIG Study Group* Should Immunoglobulin Therapy Be Used in Allogeneic Stem-Cell Transplantation? A Randomized, Double-Blind, Dose Effect, Placebo-Controlled, Multicenter Trial Ann Intern Med, July 1, 2003; 139(1): 8 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. D. DeLeve, Y. Ito, N. W. Bethea, M. K. McCuskey, X. Wang, and R. S. McCuskey Embolization by sinusoidal lining cells obstructs the microcirculation in rat sinusoidal obstruction syndrome Am J Physiol Gastrointest Liver Physiol, June 1, 2003; 284(6): G1045 - G1052. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. McDonald, J. T. Slattery, M. E. Bouvier, S. Ren, A. L. Batchelder, T. F. Kalhorn, H. G. Schoch, C. Anasetti, and T. Gooley Cyclophosphamide metabolism, liver toxicity, and mortality following hematopoietic stem cell transplantation Blood, March 1, 2003; 101(5): 2043 - 2048. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. G. Richardson, C. Murakami, Z. Jin, D. Warren, P. Momtaz, D. Hoppensteadt, A. D. Elias, J. H. Antin, R. Soiffer, T. Spitzer, et al. Multi-institutional use of defibrotide in 88 patients after stem cell transplantation with severe veno-occlusive disease and multisystem organ failure: response without significant toxicity in a high-risk population and factors predictive of outcome Blood, December 15, 2002; 100(13): 4337 - 4343. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. A. Tabbara, K. Zimmerman, C. Morgan, and Z. Nahleh Allogeneic Hematopoietic Stem Cell Transplantation: Complications and Results Arch Intern Med, July 22, 2002; 162(14): 1558 - 1566. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Prieto, J. Blanch, J. Atala, E. Carreras, M. Rovira, E. Cirera, and C. Gasto Psychiatric Morbidity and Impact on Hospital Length of Stay Among Hematologic Cancer Patients Receiving Stem-Cell Transplantation J. Clin. Oncol., April 1, 2002; 20(7): 1907 - 1917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Tamaki, H. Wada, K. Ohfuzi, T. Shibata, M. Masuya, S. Kageyama, E. C. Gabazza, K. Kawakami, K. Tsuji, E. Miyanishi, et al. Hemostatic Abnormalities Following Bone Marrow Transplantation Clinical and Applied Thrombosis/Hemostasis, April 1, 2002; 8(2): 125 - 132. [Abstract] [PDF]
|
|
|
|
|
|
G. K. K. Lau, Y.-h. Leung, D. Y. T. Fong, W.-y. Au, Y.-l. Kwong, A. Lie, J.-l. Hou, Y.-m. Wen, A. Nanj, and R. Liang High hepatitis B virus (HBV) DNA viral load as the most important risk factor for HBV reactivation in patients positive for HBV surface antigen undergoing autologous hematopoietic cell transplantation Blood, April 1, 2002; 99(7): 2324 - 2330. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. Murdter, J. Coller, A. Claviez, F. Schonberger, U. Hofmann, P. Dreger, and M. Schwab Sensitive and Rapid Quantification of Busulfan in Small Plasma Volumes by Liquid Chromatography-Electrospray Mass Spectrometry Clin. Chem., August 1, 2001; 47(8): 1437 - 1442. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Nash, J. H. Antin, C. Karanes, J. W. Fay, B. R. Avalos, A. M. Yeager, D. Przepiorka, S. Davies, F. B. Petersen, P. Bartels, et al. Phase 3 study comparing methotrexate and tacrolimus with methotrexate and cyclosporine for prophylaxis of acute graft-versus-host disease after marrow transplantation from unrelated donors Blood, September 15, 2000; 96(6): 2062 - 2068. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. K. K. Lau, A. K. W. Lie, Y. L. Kwong, C. K. Lee, J. Hou, Y. L. Lau, W. L. Lim, and R. Liang A case-controlled study on the use of HBsAg-positive donors for allogeneic hematopoietic cell transplantation Blood, July 15, 2000; 96(2): 452 - 458. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. I. Strasser, K. M. Sullivan, D. Myerson, C. L. Spurgeon, B. Storer, H. G. Schoch, C. S. Murakami, and G. B. McDonald Cirrhosis of the Liver in Long-Term Marrow Transplant Survivors Blood, May 15, 1999; 93(10): 3259 - 3266. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Nieto, P. J. Cagnoni, S. I. Bearman, E. J. Shpall, S. Matthes, T. DeBoom, A. Baron, and R. B. Jones Acute Encephalopathy: A New Toxicity Associated with High-Dose Paclitaxel Clin. Cancer Res., March 1, 1999; 5(3): 501 - 506. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. I. Strasser and G. B. McDonald Hepatitis Viruses and Hematopoietic Cell Transplantation: A Guide to Patient and Donor Management Blood, February 15, 1999; 93(4): 1127 - 1136. [Full Text] [PDF]
|
|
|
|
|
|
H. Hagglund, M. Remberger, S. Klaesson, B. Lonnqvist, P. Ljungman, and O. Ringden Norethisterone Treatment, a Major Risk-Factor for Veno-Occlusive Disease in the Liver After Allogeneic Bone Marrow Transplantation Blood, December 15, 1998; 92(12): 4568 - 4572. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Carreras, H. Bertz, W. Arcese, J.-P. Vernant, J.-F. Tomas, H. Hagglund, G. Bandini, H. Esperou, J. Russell, J. de la Rubia, et al. Incidence and Outcome of Hepatic Veno-Occlusive Disease After Blood or Marrow Transplantation: A Prospective Cohort Study of the European Group for Blood and Marrow Transplantation Blood, November 15, 1998; 92(10): 3599 - 3604. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. G. Richardson, A. D. Elias, A. Krishnan, C. Wheeler, R. Nath, D. Hoppensteadt, N. M. Kinchla, D. Neuberg, E. K. Waller, J. H. Antin, et al. Treatment of Severe Veno-Occlusive Disease With Defibrotide: Compassionate Use Results in Response Without Significant Toxicity in a High-Risk Population Blood, August 1, 1998; 92(3): 737 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. D. Ford, W. Reilly, J. Wood, D. C. Classen, and J. P. Burke Oral Antimicrobial Prophylaxis in Bone Marrow Transplant Recipients: Randomized Trial of Ciprofloxacin versus Ciprofloxacin-Vancomycin Antimicrob. Agents Chemother., June 1, 1998; 42(6): 1402 - 1405. [Abstract] [Full Text]
|
|
|
|
|
|
A. Locasciulli, M. Testa, M. G. Valsecchi, L. Vecchi, D. Longoni, P. Sparano, A. Rovelli, C. Uderzo, G. Masera, and A. Alberti Morbidity and Mortality Due to Liver Disease in Children Undergoing Allogeneic Bone Marrow Transplantation: A 10-Year Prospective Study Blood, November 1, 1997; 90(9): 3799 - 3805. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Salzberger, R. A. Bowden, R. C. Hackman, C. Davis, and M. Boeckh Neutropenia in Allogeneic Marrow Transplant Recipients Receiving Ganciclovir for Prevention of Cytomegalovirus Disease: Risk Factors and Outcome Blood, September 15, 1997; 90(6): 2502 - 2508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. G. Sturgill and G. H. Lambert Xenobiotic-induced hepatotoxicity: mechanisms of liver injury and methods of monitoring hepatic function Clin. Chem., August 1, 1997; 43(8): 1512 - 1526. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Salat, E. Holler, H.-J. Kolb, B. Reinhardt, R. Pihusch, W. Wilmanns, and E. Hiller Plasminogen Activator Inhibitor-1 Confirms the Diagnosis of Hepatic Veno-Occlusive Disease in Patients With Hyperbilirubinemia After Bone Marrow Transplantation Blood, March 15, 1997; 89(6): 2184 - 2188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. I. Bearman, J. L. Lee, A. E. Baron, and G. B. McDonald Treatment of Hepatic Venocclusive Disease With Recombinant Human Tissue Plasminogen Activator and Heparin in 42 Marrow Transplant Patients Blood, March 1, 1997; 89(5): 1501 - 1506. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Nash, T. Gooley, C. Davis, and F. R. Appelbaum The Problem of Thrombocytopenia after Hematopoietic Stem Cell Transplantation Oncologist, December 1, 1996; 1(6): 371 - 380. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. B. Miller and F. M. Graeme-Cook Case 19-1996- Multisystem failure in a 33-year-old man after bone marrow transplantation N. Engl. J. Med., June 20, 1996; 334(25): 1655 - 1662. [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. O'Marcaigh and D. L. Betcher Busulfan Journal of Pediatric Oncology Nursing, January 1, 1996; 13(3): 150 - 152. [PDF]
|
|
|
|
|
|
W. M. Lee Drug-Induced Hepatotoxicity N. Engl. J. Med., October 26, 1995; 333(17): 1118 - 1127. [Full Text] [PDF]
|
|
|
|
|
|
W. M. Lee Acute Liver Failure N. Engl. J. Med., December 16, 1993; 329(25): 1862 - 1872. [Full Text]
|
|
Article
