VENO-OCCLUSIVE DISEASE OF THE LIVER AFTER BONE-MARROW TRANSPLANTATION - DIAGNOSIS, INCIDENCE, AND PREDISPOSING FACTORS
VENO-OCCLUSIVE DISEASE OF THE LIVER AFTER BONE-MARROW TRANSPLANTATION - DIAGNOSIS, INCIDENCE, AND PREDISPOSING FACTORS
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DOI：
10.1002/hep.1840040121
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发表时间：
1984-01-01
期刊：
影响因子：
13.5
通讯作者：
THOMAS, ED
中科院分区：
文献类型：
--
作者：
MCDONALD, GB;SHARMA, P;THOMAS, ED
肝静脉闭塞性疾病（VOD）是一种肝小静脉的纤维性闭塞，可由放化疗引起。本文回顾了1978-1980年间255例因恶性肿瘤接受骨髓移植的病人，以确定VOD的发生率和诱发因素。在255例患者中，53例符合VOD标准，发生率为21%。多因素分析显示VOD最重要的危险因素是年龄超过15岁，这是一种潜在的恶性肿瘤，而不是移植前的急性淋巴细胞白血病和肝炎。肝炎患者发生VOD的风险是血清谷草转氨酶正常患者的3.4倍（P = 0.0004）。在这种情况下，肝炎可能是非甲非乙型病毒病因，并代表了骨髓移植的相对禁忌症，因为预处理放化疗的毒性增强。
Venocclusive disease (VOD) of the liver, a fibrous obliteration of small hepatic venules, can be caused by chemoradiation therapy. A total of 255 consecutive patients undergoing bone marrow transplantation for malignancy during 1978-1980 were reviewed in order to determine the incidence of VOD and the predisposing factors. Of 255 patients, 53 met the criteria for VOD, for an incidence of 21%. Multivariate analysis showed that the most significant risk factors for VOD were age over 15, an underlying malignancy other than acute lymphocytic leukemic and hepatitis prior to transplantation. Patients with hepatitis had a 3.4-fold risk of developing VOD, as compared to patients with normal SGOT [serum glutamic oxaloacetic transaminase] values (P = 0.0004). Hepatitis in this setting is probably of non-A, non-B viral etiology and represents a relative contraindication to marrow transplantation because of enhanced toxicity from conditioning chemoradiotherapy.