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Pediatric Transplants

Hepatic veno-occlusive disease in children after hematopoietic stem cell transplantation: incidence, risk factors, and outcome

Bone Marrow Transplantation volume 45, pages 1287–1293 (2010)Cite this article

Abstract

Four hundred and sixty-seven hematopoietic stem cell transplantations (HSCTs) (217 autologous and 250 allogeneic HSCT) were performed in 374 children at four pediatric HSCT centers in Korea from January 2005 to December 2007. Among 467 transplants, veno-occlusive disease (VOD) developed in 72 transplants (15.4%) at a median of 10 days after HSCT. Multivariate analysis showed that BU or TBI-containing regimen (P=0.002), VOD prophylaxis without lipo-prostaglandin E1 (PGE1) (P=0.012), number of previous HSCT (P=0.014), and pretransplant serum ferritin (P=0.018) were independent risk factors for developing VOD. Mean serum ferritin levels were significantly higher in HSCT with VOD (2109.6±2842.5 ng/ml) than in HSCT without VOD (1315.9±1094.4 ng/ml) (P<0.001). The relative risk of death within 100 days of HSCT in transplants with VOD compared with transplants without VOD was 3.39 (confidence interval: 1.78–6.45). Our results suggest that lipo-PGE1 might have a protective effect against the development of VOD, and pretransplant serum ferritin could act as a risk factor for VOD. A larger prospective study is needed to confirm a possible role of lipo-PGE1 and iron chelation therapy in reducing the incidence of VOD.

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Acknowledgements

This study was supported by a Korea Childhood Leukemia Foundation, by a grant of the Korea Healthcare Technology R&D Project, Ministry of Health, Welfare and Family affairs, Republic of Korea (A080588) and by a grant from the National R&D Program for Cancer Control, Ministry for Health, Welfare and Family affairs, Republic of Korea (0520290).

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Authors and Affiliations

  1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    S H Lee, K H Yoo, K W Sung & H H Koo

  2. Pediatric Oncology Clinic, National Cancer Center, Goyang, Republic of Korea

    Y J Kwon, M M Kwon, H J Park & B-K Park

  3. Korea Childhood Leukemia Foundation, Seoul, Republic of Korea

    Y Y Kim

  4. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    J A Park, H J Im & J J Seo

  5. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea

    H J Kang, H Y Shin & H S Ahn

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Lee, S., Yoo, K., Sung, K. et al. Hepatic veno-occlusive disease in children after hematopoietic stem cell transplantation: incidence, risk factors, and outcome. Bone Marrow Transplant 45, 1287–1293 (2010). https://doi.org/10.1038/bmt.2009.349

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