Veno-Occlusive Disease of the Liver After Allogeneic Bone Marrow Transplantation

Possible Association with Graft-Versus-Host Disease

  1. PAUL D. BERK, M.D.;
  2. HANS POPPER, M.D., Ph.D.;
  3. GERHARD R. F. KRUEGER, M.D.;
  4. JULIAN DECTER, M.D.;
  5. GEOFFREY HERZIG, M.D.; and
  6. ROBERT G. GRAW, Jr., M.D.
  1. New York, New York, and Bethesda, Maryland

    Abstract

    Acute veno-occlusive disease of the liver developed in seven of 29 patients undergoing bone marrow transplantation for treatment of leukemia, aplastic anemia, or disseminated carcinomatosis. All seven died despite successful marrow engraftment. Hepatic failure was the principal cause of death in four and contributory in three. The veno-occlusive disease did not relate to the nature of the pretransplant immunosuppressive regimen, since it occurred in patients receiving irradiation alone, chemotherapy alone, or both. Twenty-two of the patients were autopsied. Among these, the lesion was found in seven of 11 in whom a graft-versus-host reaction developed but in none of the 11 without such a reaction who had received similar pretransplant immunosuppression (P < 0.025). Hence, acute veno-occlusivedisease of the liver appears to be a complication of allogeneic bone marrow transplantation related to the development of a graft-versus-host reaction.

    Article and Author Information

    • ▸From the Division of Hematology, Department of Medicine, and the Stratton Laboratory for the Study of Liver Disease, Mount Sinai School of Medicine of the City University of New York; New York, New York; and the Section on Diseases of the Liver, Digestive Diseases Branch, National Institute of Arthritis, Metabolism, and Digestive Diseases, and the Experimental Hematology Section, Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health; Bethesda, Maryland.

    • ▸Requests for reprints should be addressed to Paul D. Berk, M.D.; Division of Hematology, The Mount Sinai Medical Center, Berg Building, 100th St. and Fifth Ave.; New York, NY 10029.

      • Received September 28, 1977.
      • Accepted November 1, 1978.
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    This Article

    1. Ann Intern Med February 1, 1979 vol. 90 no. 2 158-164
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