Experience from a single paediatric transplant centre with identification of some protective and risk factors concerning the development of hepatic veno-occlusive disease in children after allogeneic hematopoietic stem cell transplant

N. Maximova, G. Ferrara, M. Minute, A. Pizzol, V. Kiren, M. Montico, M. Gregori, P. Tamaro

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12 Citations (Scopus)

Abstract

Hepatic veno-occlusive disease (VOD) is a frequent and severe complication of hematopoietic stem cell transplantation (HSCT) affecting 9.6-17.3% of cases. 200 HSCT, performed between January 1995 and March 2013 in our Paediatric HSCT Centre in Trieste, were retrospectively analysed to evaluate the frequency of VOD and to identify the associated risk factors. The frequency of VOD according to the Seattle criteria was 17%, within the range reported in literature. The mortality rate was 37.5% (75 out of 200 transplantations) in the general population and 73.5% (25 out of 34) in VOD patients (p <0.05). Veno-occlusive disease significantly decreased from 38% (1995-2000) to 8% (2007-2013) p <0.05. Univariate and multivariate analyses identified sepsis and pre-transplant ferritin levels above 1000 ng/ml as two significant risk factors for VOD, while the use of tacrolimus appeared to be associated with a lower VOD risk. Veno-occlusive disease still remains an important cause of transplant-related mortality even if it appears to have decreased over the last few years.

Original languageEnglish
Pages (from-to)766-772
Number of pages7
JournalInternational Journal of Hematology
Volume99
Issue number6
DOIs
Publication statusPublished - 2014

Fingerprint

Hepatic Veno-Occlusive Disease
Hematopoietic Stem Cells
Pediatrics
Transplants
Hematopoietic Stem Cell Transplantation
Mortality
Tacrolimus
Ferritins
Protective Factors
Sepsis
Multivariate Analysis
Transplantation

Keywords

  • Defibrotide
  • HSCT
  • Mortality
  • Tacrolimus
  • VOD

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

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title = "Experience from a single paediatric transplant centre with identification of some protective and risk factors concerning the development of hepatic veno-occlusive disease in children after allogeneic hematopoietic stem cell transplant",
abstract = "Hepatic veno-occlusive disease (VOD) is a frequent and severe complication of hematopoietic stem cell transplantation (HSCT) affecting 9.6-17.3{\%} of cases. 200 HSCT, performed between January 1995 and March 2013 in our Paediatric HSCT Centre in Trieste, were retrospectively analysed to evaluate the frequency of VOD and to identify the associated risk factors. The frequency of VOD according to the Seattle criteria was 17{\%}, within the range reported in literature. The mortality rate was 37.5{\%} (75 out of 200 transplantations) in the general population and 73.5{\%} (25 out of 34) in VOD patients (p <0.05). Veno-occlusive disease significantly decreased from 38{\%} (1995-2000) to 8{\%} (2007-2013) p <0.05. Univariate and multivariate analyses identified sepsis and pre-transplant ferritin levels above 1000 ng/ml as two significant risk factors for VOD, while the use of tacrolimus appeared to be associated with a lower VOD risk. Veno-occlusive disease still remains an important cause of transplant-related mortality even if it appears to have decreased over the last few years.",
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T1 - Experience from a single paediatric transplant centre with identification of some protective and risk factors concerning the development of hepatic veno-occlusive disease in children after allogeneic hematopoietic stem cell transplant

AU - Maximova, N.

AU - Ferrara, G.

AU - Minute, M.

AU - Pizzol, A.

AU - Kiren, V.

AU - Montico, M.

AU - Gregori, M.

AU - Tamaro, P.

PY - 2014

Y1 - 2014

N2 - Hepatic veno-occlusive disease (VOD) is a frequent and severe complication of hematopoietic stem cell transplantation (HSCT) affecting 9.6-17.3% of cases. 200 HSCT, performed between January 1995 and March 2013 in our Paediatric HSCT Centre in Trieste, were retrospectively analysed to evaluate the frequency of VOD and to identify the associated risk factors. The frequency of VOD according to the Seattle criteria was 17%, within the range reported in literature. The mortality rate was 37.5% (75 out of 200 transplantations) in the general population and 73.5% (25 out of 34) in VOD patients (p <0.05). Veno-occlusive disease significantly decreased from 38% (1995-2000) to 8% (2007-2013) p <0.05. Univariate and multivariate analyses identified sepsis and pre-transplant ferritin levels above 1000 ng/ml as two significant risk factors for VOD, while the use of tacrolimus appeared to be associated with a lower VOD risk. Veno-occlusive disease still remains an important cause of transplant-related mortality even if it appears to have decreased over the last few years.

AB - Hepatic veno-occlusive disease (VOD) is a frequent and severe complication of hematopoietic stem cell transplantation (HSCT) affecting 9.6-17.3% of cases. 200 HSCT, performed between January 1995 and March 2013 in our Paediatric HSCT Centre in Trieste, were retrospectively analysed to evaluate the frequency of VOD and to identify the associated risk factors. The frequency of VOD according to the Seattle criteria was 17%, within the range reported in literature. The mortality rate was 37.5% (75 out of 200 transplantations) in the general population and 73.5% (25 out of 34) in VOD patients (p <0.05). Veno-occlusive disease significantly decreased from 38% (1995-2000) to 8% (2007-2013) p <0.05. Univariate and multivariate analyses identified sepsis and pre-transplant ferritin levels above 1000 ng/ml as two significant risk factors for VOD, while the use of tacrolimus appeared to be associated with a lower VOD risk. Veno-occlusive disease still remains an important cause of transplant-related mortality even if it appears to have decreased over the last few years.

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