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Graft-versus-Host Disease

Successful treatment of hepatic veno-occlusive disease after myeloablative allogeneic hematopoietic stem cell transplantation by early administration of a short course of methylprednisolone

Bone Marrow Transplantation volume 41, pages 287–291 (2008)Cite this article

Abstract

Hepatic veno-occlusive disease (VOD) is one of the most common and important regimen-related toxicities observed after hematopoietic stem cell transplantation (HSCT). There are no universally accepted preventative or therapeutic approaches for VOD. We prospectively evaluated the safety and efficacy of a short course of methylprednisolone (MP) in 48 patients undergoing allogeneic HSCT who were diagnosed with hepatic VOD. MP was administered at a dose of 0.5 mg/kg i.v. every 12 h for a total of 14 doses, and then discontinued without taper. Thirty (63%) patients responded with a reduction in total serum bilirubin of 50% or more after 10 days of treatment. In univariate analysis, non-responders had a higher total bilirubin at the start of MP therapy, more weight gain, evidence of fungal infection and platelet refractoriness. High SGPT and early engraftment were significant factors among responders. Twenty-five of the 30 responders survived up to day +100, whereas all but three non-responders died within 100 days post-HSCT, for a probability of survival of 58% among responders and 10% for non-responders. Prospective comparative studies are needed to confirm the observed encouraging outcome of MP therapy for VOD.

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Acknowledgements

We thank Mr Ibrahim El Hassan, MPH, for his help in the statistical analysis and Mr Edgardo Colcol for his help in the data management of this study.

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Authors and Affiliations

  1. King Faisal Cancer Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    A Al Beihany, H Al Omar, E Sahovic, N Chaudhri, F Al Mohareb, F Al Sharif, H Al Zahrani, A Al Shanqeeti, P Seth, S Zaidi, M Morshed, K Al Anazi, M Gyger & M Aljurf

  2. Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    G Mohamed

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  1. A Al Beihany
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Correspondence to M Aljurf.

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Al Beihany, A., Al Omar, H., Sahovic, E. et al. Successful treatment of hepatic veno-occlusive disease after myeloablative allogeneic hematopoietic stem cell transplantation by early administration of a short course of methylprednisolone. Bone Marrow Transplant 41, 287–291 (2008). https://doi.org/10.1038/sj.bmt.1705896

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  • DOI: https://doi.org/10.1038/sj.bmt.1705896

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