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Hepatic veno occlusive disease

Simone Cesaro, Margherita Mauro, Giulia Sattin, Maria Teresa Sartori, Graziella Saggiorato, Alessandra Paratella, Gloria Tridello, Gianni Bisogno
BACKGROUND: Hepatic veno-occlusive (VOD) disease has been described in hematopoietic stem cell transplantation (HSCT), solid tumors, and acute lymphoblastic leukemia. The incidence of VOD in Wilms tumor (WT) ranges from 1.2% to 8%. The diagnosis of VOD is clinical, and there are no validated laboratory biomarkers. PROCEDURE: We prospectively evaluated the specificity and sensitivity of plasminogen-activator inhibitor-1 (PAI-1) and protein C as diagnostic markers of VOD in WT patients...
March 13, 2019: Pediatric Blood & Cancer
Paul Richardson, Saurabh Aggarwal, Ozlem Topaloglu, Kathleen F Villa, Selim Corbacioglu
Veno-occlusive disease (VOD), also called sinusoidal obstruction syndrome (SOS), is a potentially life-threatening complication of hematopoietic stem cell transplantation (HSCT) conditioning or high-dose nontransplant chemotherapy. VOD/SOS with multi-organ dysfunction (MOD) is associated with a mortality rate of > 80%. Defibrotide (25 mg/kg/day) is approved to treat hepatic VOD/SOS with renal or pulmonary dysfunction post HSCT in the United States and to treat severe hepatic VOD/SOS in patients > 1 month of age in the European Union...
February 25, 2019: Bone Marrow Transplantation
Selim Corbacioglu, Elias J Jabbour, Mohamad Mohty
Veno-occlusive disease, also known as sinusoidal obstruction syndrome (VOD/SOS), is a potentially life-threatening complication of allogeneic or autologous hematopoietic stem cell transplantation (HSCT), most commonly associated with high-intensity chemotherapies. Since development of VOD/SOS may be rapid and unpredictable, the importance of identifying risk factors to facilitate prompt diagnosis and timely treatment has become increasingly well recognized. Reporting of new retrospective study data for adults and children and emergence of novel anti-cancer therapies that may increase risk of VOD/SOD also necessitate updates on risk factors, as provided in this review...
February 21, 2019: Biology of Blood and Marrow Transplantation
Chien-Chang Lee, Hsiu-Hao Chang, Meng-Yao Lu, Yung-Li Yang, Shu-Wei Chou, Dong-Tsamn Lin, Shiann-Tarng Jou, Ming Yao, Chi-Cheng Li, Su-Peng Yeh, Mei-Hui Chen, Jyh-Pyng Gau, Sin-Syue Li, Po-Nan Wang, Yi-Chang Liu, Tso-Fu Wang, Tran-Der Tan, Ming-Yang Lee, Ming-Sun Yu, Chuan-Cheng Wang, Shih-Chiang Lin, Yeu-Chin Chen, Yung-Cheng Su, Ko-Ying Su, Kai-Hsin Lin
Hepatic veno-occlusive disease (VOD) is a potentially fatal complication of hematopoietic stem cell transplantation (HSCT). We conducted this study to investigate the incidence and risk factors of hepatic VOD for patients receiving HSCT in Taiwan. We retrospectively analyzed the data from a nationwide registry for patients receiving HSCT, which was collected by the Taiwan Society of Blood and Marrow Transplantation. The data collection period was from 2009 to 2014. A total 2345 patients were reviewed and 39 patients among them were diagnosed as having hepatic VOD...
January 21, 2019: Annals of Hematology
Johanna Ebmeyer, Jessica Behrend, Mario Lorenz, Georgia Günther, Raymond Reif, Jan G Hengstler, Albert Braeuning, Alfonso Lampen, Stefanie Hessel-Pras
Pyrrolizidine alkaloids (PA) are a group of secondary plant metabolites belonging to the most widely distributed natural toxins. PA intoxication of humans leads to severe liver damage, such as hepatomegaly, hepatic necrosis, fibrosis and cirrhosis. An acute consequence observed after ingestion of high amounts of PA is veno-occlusive disease (VOD) where the hepatic sinusoidal endothelial cells are affected. However, the mechanisms leading to VOD after PA intoxication remain predominantly unknown. Thus, we investigated PA-induced molecular effects on human umbilical vein endothelial cells (HUVEC)...
November 19, 2018: Chemico-biological Interactions
Yan Wang, Dan Qiao, Ya Li, Feng Xu
BACKGROUND: Hepatic veno-occlusive disease (HVOD) caused by Gynura segetum has been increasingly reported in China in recent years. The aim of this retrospective study was to identify independent prognostic markers for survival in patients with Gynura segetum-induced HVOD and to evaluate the effect of anticoagulants and transjugular intrahepatic portosystemic shunt (TIPS) on survival rate. METHODS: Clinical data including symptoms, signs, imaging characteristics, laboratory test results, results of liver tissue biopsies, type of treatment during follow-up and clinical outcomes were collected...
October 26, 2018: BMC Gastroenterology
Anselm Chi-Wai Lee, LeLe Aung
In our institution, hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) has been treated with N-acetylcysteine (NAC) since 2008-a loading dose of 150 mg/kg, followed by 12 doses of 70 mg/kg 6 hourly. Nine children were diagnosed with hepatic VOD/SOS. Hepatic VOD/SOS occurred in seven children after stem cell transplantation and two were receiving chemotherapy for Wilms tumor. Their clinical severity was classified as moderate in two and severe in seven by the European Society for Blood and Marrow Transplantation criteria...
October 23, 2018: Pediatric Blood & Cancer
Satoshi Takada, Tomoharu Miyashita, Yasuhiko Yamamoto, Shunsuke Kanou, Seiichi Munesue, Yoshinao Ohbatake, Shinichi Nakanuma, Koichi Okamoto, Seisho Sakai, Jun Kinoshita, Isamu Makino, Keishi Nakamura, Hidehiro Tajima, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, Tetsuo Ohta
BACKGROUND: Hepatic sinusoidal obstruction syndrome (SOS), also known as veno-occlusive disease, is a form of drug-induced liver injury, the initial morphological changes associated with which occur in liver sinusoidal endothelial cells (LSECs). Recombinant human soluble thrombomodulin (rTM) is reported to have anti-inflammatory and cytoprotective effects. Therefore, we investigated the ability of rTM to protect endothelial cells and enhance their functions in a monocrotaline (MCT)-induced model of SOS...
November 2018: In Vivo
B K Straub, D A Ridder, A Schad, C Loquai, J M Schattenberg
BACKGROUND: Drug-induced liver injury is increasing, especially in elderly patients with polymedication and multimorbidity. OBJECTIVES: Clinicopathologic correlation of immune-mediated liver injury, specifically liver injury following therapy with immune checkpoint inhibitors against PD-1, PDL-1, and CTLA4. METHODS: Histologic assessment of liver biopsies of nine patients after therapy with immune checkpoint inhibitors and correlation with clinical parameters...
November 2018: Der Pathologe
Paul G Richardson, Stephan A Grupp, Antonio Pagliuca, Amrita Krishnan, Vincent T Ho, Selim Corbacioglu
Hepatic veno-occlusive disease, also called sinusoidal obstruction syndrome (VOD/SOS), is a potentially life-threatening and unpredictable complication of hematopoietic stem cell transplantation (HSCT). Characterized by a prothrombotic-hypofibrinolytic state, VOD/SOS typically presents with hyperbilirubinemia, ascites, weight gain and painful hepatomegaly; VOD/SOS with multiorgan failure may be associated with >80% mortality. Treatment has been mainly supportive. However, defibrotide is now approved in the USA for treatment of hepatic VOD/SOS with renal or pulmonary dysfunction following HSCT and in the European Union for treatment of severe hepatic VOD/SOS post-HSCT...
November 2017: International Journal of Hematologic Oncology
Sophia Delicou, Konstantinos Maragkos, Maria Tambaki, Dimitrios Kountouras, John Koskinas
Sickle cell disease patients often need regular blood transfusions to improve both the quality of life and survival from the veno-occlusive complications of the disease. Deferasirox, a convenient long acting oral agent, has recently been introduced in clinical practice with promising efficacy. This study aims to evaluate the association of liver stiffness and possible fibrosis with iron deposition and confirm the use of elastography as a validated test of responding to chelation with low cost and easy access...
2018: Mediterranean Journal of Hematology and Infectious Diseases
Xinke Zhang, Xue Song, Lorena Lopez-Gonzalez, Krutika Jariwala-Parikh, Vadim Romanov, Ze Cong
PURPOSE: The goal of this study was to evaluate the incidence, inpatient mortality, and economic burden of hepatic veno-occlusive disease (VOD) in adults with B-cell acute lymphoblastic leukemia (ALL) in the United States. METHODS: Using MarketScan Commercial Claims and Encounters Database and Medicare Supplemental and Coordination of Benefits Database, data for patients with B-cell ALL from April 1, 2009, to October 31, 2016, were extracted by using diagnosis codes...
October 2018: Clinical Therapeutics
Tal Schechter, Evelio Perez-Albuerne, Tiffany F Lin, Meredith S Irwin, Mohammed Essa, Ami V Desai, Haydar Frangoul, Gregory Yanik, L Lee Dupuis, David Jacobsohn, Morris Kletzel, Mark Ranalli, Sandeep Soni, Alix E Seif, Stephan Grupp, Christopher C Dvorak
Survival for high-risk neuroblastoma patients is still suboptimal. Although stem cell transplantation (SCT) is used, there is no consensus as to which conditioning regimen has the greatest efficacy and fewest toxicities. We assessed the incidence of and risk for hepatic veno-occlusive disease (VOD) for neuroblastoma patients who underwent autologous SCT with busulfan and melphalan (BuMel) at eight centers following Children's Oncology Group (COG)-based induction chemotherapy. Data regarding the patients, SCT characteristics, busulfan steady-state concentrations, incidence of VOD, and survival were evaluated...
September 4, 2018: Bone Marrow Transplantation
Lindsey E Roeker, Haesook T Kim, Brett Glotzbecker, Prashant Nageshwar, Sarah Nikiforow, John Koreth, Philippe Armand, Corey Cutler, Edwin P Alyea, Joseph H Antin, Paul G Richardson, Robert J Soiffer, Vincent T Ho
Hepatic veno-occlusive disease (VOD), or sinusoidal obstruction syndrome (SOS), is a serious complication of hematopoietic stem cell transplantation (HSCT) with mortality in its severe form exceeding 80%. Although the incidence of VOD/SOS has fallen with contemporary transplantation practices, the increasing use of inotuzumab, the return of gemtuzumab, and the popularity of pharmacokinetic-guided high-dose busulfan may impact incidence. Early intervention with defibrotide improves survival, but prompt diagnosis can be difficult...
January 2019: Biology of Blood and Marrow Transplantation
W Liu, Y Li, Z X Qiu, Y Yin, Y H Sun, W L Xu, Q Wang, Z Y Liang, Y J Dong, L H Wang, Q N Cen, M J Wang, W S Wang, J P Ou, H Y Ren
Objective: To investigate the therapeutic effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with FLAG sequential busulfan/cyclophosphamide(Bu/Cy) conditioning regimen for refractory/relapsed acute myeloid leukemia. Methods: From February 2012 to June 2017, 21 patients with refractory/relapsed acute myeloid leukemia underwent allo-HSCT with FLAG sequential Bu/Cy conditioning regimen. Transplantation-related complications and clinical outcome were retrospectively analyzed. Results: After conditioning, no hepatic veno-occlusive disease (VOD) and grade Ⅲ hemorrhagic cystitis occurred...
August 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
C J Qin, L J Liu, Z M Zhang, L Luo, Y R Lai, Q C Li
Objective: To analyze the outcome and the prognostic factors of hepatic veno-occlusive disease (HVOD) after hematopoietic stem cell transplantation (HSCT). Methods: A total of 797 patients receiving HSCT were analyzed retrospectively. The prophylaxis regimen of HVOD in the First Affiliated Hospital of Guangxi Medical University consisted of low molecular weight heparin and lipoprostaglandin E1 (PGE1). Results: Fifty-nine patients (7.4%) developed HVOD at 3-49 days after HSCT (median 12 days). Age younger than 15 years at transplant( HR = 6...
July 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Emmanuelle Tavernier, Emilie Chalayer, Jérôme Cornillon, Anne Pouvaret, Jean-Alain Martignoles, François Casteillo, Jérémy Terreaux, Elisabeth Daguenet, Denis Guyotat
BACKGROUND: Hepatic veno-occlusive disease, also called sinusoidal obstruction syndrome (SOS/VOD), is a potentially fatal complication of allogeneic or autologous hematopoietic stem cell transplantation. A plethora of transplant and patient-related risk factors predispose to SOS/VOD and should be taken into account for prognosis assessment as well as for adequate therapeutic intervention. CASE PRESENTATION: We describe the case of a mantle cell lymphoma patient who developed a fulminant hepatitis following oxaliplatin-containing intensive chemotherapy and autologous transplantation...
July 3, 2018: BMC Research Notes
Paul G Richardson, Enric Carreras, Massimo Iacobelli, Bijan Nejadnik
Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is a potentially life-threatening complication of conditioning during hematopoietic stem cell transplantation (HSCT) or chemotherapy without HSCT, with a historically reported mean incidence of 13.7% post-HSCT. Typical symptoms of VOD/SOS may include hyperbilirubinemia, painful hepatomegaly, weight gain, and ascites. Defibrotide, a polydisperse mixture of predominantly single-stranded polydeoxyribonucleotides, is currently the only therapy approved to treat hepatic VOD/SOS with pulmonary/renal dysfunction (ie, multiorgan dysfunction/multiorgan failure [MOD/MOF]) following HSCT in the United States and to treat severe hepatic VOD/SOS post-HSCT in the European Union...
June 26, 2018: Blood Advances
Christopher Strouse, Ying Zhang, Mei-Jie Zhang, Alyssa DiGilio, Marcelo Pasquini, Mary M Horowitz, Stephanie Lee, Vincent Ho, Muthalagu Ramanathan, Wichai Chinratanalab, Alison Loren, Linda J Burns, Andrew Artz, Kathleen F Villa, Wael Saber
A risk score identifying patients at high risk for veno-occlusive disease (VOD) may aid efforts to study preventive strategies for this uncommon complication of hematopoietic cell transplantation (HCT). Patients receiving a first allogeneic HCT between 2008 and 2013 as reported to the Center for International Blood and Marrow Transplant Research (N = 13,097) were randomly divided into training and validation sets. Independent prognostic factors for development of VOD by day +100 after HCT were identified with a multivariate logistic regression model...
October 2018: Biology of Blood and Marrow Transplantation
Farhad Khimani, George B McDonald, Howard M Shulman, Brian Betts, Frederick Locke, Hugo Fernandez, Claudio Anasetti, Joseph Pidala
Sirolimus-based graft vs. host disease (GVHD) prophylaxis is associated with higher incidence of veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) after allogeneic hematopoietic cell transplantation (HCT). However, whether the clinical manifestations and prognosis of VOD/SOS differs when diagnosed in the setting of sirolimus-based GVHD prophylaxis is not well studied. To address this question, we examined presenting features and treatment outcome of VOD/SOS cases identified in a large retrospective cohort of consecutive HCT procedures (n = 818 total, sirolimus (SIR)/tacrolimus (TAC) n = 308, and methotrexate (MTX) or mycophenolate mofetil (MMF)/TAC n = 510)...
June 12, 2018: Bone Marrow Transplantation
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