Risk factors for hepatic veno-occlusive disease following HLA-identical sibling bone marrow transplants for leukemia.
Risk factors for hepatic veno-occlusive disease following HLA-identical sibling bone marrow transplants for leukemia.
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发表时间：
1996
影响因子：
4.8
通讯作者：
C. Rozman;E. Carreras;C. Qian;R. Gale;M. Bortin;P. Rowlings;R. Ash;R. Champlin;P. Henslee‐Downey;R. Herzig;W. Hinterberger;J. Klein;H. Prentice;J. Reiffers;F. Zwaan;M. Horowitz
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作者：
C. Rozman;E. Carreras;C. Qian;R. Gale;M. Bortin;P. Rowlings;R. Ash;R. Champlin;P. Henslee‐Downey;R. Herzig;W. Hinterberger;J. Klein;H. Prentice;J. Reiffers;F. Zwaan;M. Horowitz
目的是分析异基因骨髓移植后肝静脉闭塞性疾病（VOD）的危险因素。我们研究了1988年至1990年间，在全世界200个移植小组中，1717例HLA相合同胞白血病移植受者的队列。如果肝组织表现出典型的组织学特征或如果患者具有以下三种情况，则将其评分为患有VOD：（1）黄疸;（2）肝肿大和右上腹疼痛;和（3）腹水和/或不明原因的体重增加。移植后存活超过7天而没有VOD的组织学或任何这些临床特征的患者被归类为没有VOD。将95例VOD患者的患者、疾病和移植相关特征与1514例无VOD患者进行比较。与VOD风险增加相关的变量是：与全身放疗相比，移植前白消安和环磷酰胺预处理（相对风险（RR）2.8; P 20年（RR 1.8; P = 0.05）。在接受放射治疗的患者中，静脉注射免疫球蛋白可降低VOD风险（RR 0.26; P = 0.003）。该分析确定了VOD的风险因素。这些数据表明，修改移植方案，以减少VOD的风险，哪些患者可能是合适的主题VOD预防策略的试验几种策略。
The objective was to analyze risk factors for veno-occlusive disease of the liver (VOD) after allogeneic bone marrow transplantation. A cohort of 1717 recipients of HLA-identical sibling transplants for leukemia between 1988 and 1990, in 200 transplant teams worldwide, was studied. Patients were scored as having VOD if liver tissue showed typical histologic features or if they had all three of the following: (1) jaundice; (2) hepatomegaly and right upper quadrant abdominal pain; and (3) ascites and/or unexplained weight gain. Patients surviving more than 7 days post-transplant without histologic or any of these clinical features of VOD were classified as not having VOD. Patient-, disease- and transplant-related characteristics of 95 patients with VOD were compared to those of 1514 without VOD. Variables correlated with an increased risk of VOD were: pretransplant conditioning with busulfan and cyclophosphamide compared to total body radiation (relative risk (RR) 2.8; P 20 years (RR 1.8; P = 0.05). In patients receiving radiation for conditioning, intravenous immune globulin decreased VOD risk (RR 0.26; P = 0.003). This analysis identifies risk factors for VOD. The data suggest several strategies for modifying transplant regimens to reduce VOD risk and which patients might be suitable subjects for trials of strategies of VOD prevention.