Low incidence of hepatic veno-occlusive disease in pediatric patients undergoing hematopoietic stem cell transplantation attributed to a combination of intravenous heparin, oral glutamine, and ursodiol at a single transplant institution.

Abstract

We report the low incidence of hepatic VOD in pediatric patients with various diagnoses including hematologic malignancies and non-malignant conditions transplanted at our institution. Retrospective review of 188 patients who underwent HSCT and received a combined prophylactic regimen of intravenous heparin, oral glutamine, and ursodiol was undertaken. Analysis of the outcome of VOD revealed only one clinical case with acute myeloid leukemia; the patient developed hepatic VOD 10 days after receiving myeloablative chemotherapy with busulfan and CTX followed by HLA-matched related peripheral blood stem cell transplantation. The low incidence of hepatic VOD in an otherwise high-risk pediatric transplant population is an important observation, which may be partly attributed to this prophylactic regimen, and warrants further randomized clinical trials for confirmation.

• Authors: Sonali Lakshminarayanan, Indira Sahdev, Meena Goyal, Adrianna Vlachos, Mark Atlas, Jeffrey M Lipton
• Journal: Pediatric transplantation (Pediatr Transplant) Vol. 14 Issue 5 Pg. 618-21 (Aug 2010) ISSN: 1399-3046 [Electronic] Denmark
• PMID: 20051023 (Publication Type: Journal Article)

Chemical References

• Anticoagulants
• Glutamine
• Ursodeoxycholic Acid
• Heparin

Topics

• Adolescent
• Anticoagulants (therapeutic use)
• Chemoprevention
• Child
• Child, Preschool
• Female
• Glutamine (therapeutic use)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Heparin (therapeutic use)
• Hepatic Veno-Occlusive Disease (epidemiology, etiology, prevention & control)
• Humans
• Incidence
• Infant
• Male
• Ursodeoxycholic Acid (therapeutic use)
• Young Adult