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Norethisterone treatment, a major risk-factor for veno-occlusive disease in the liver after allogeneic bone marrow transplantation.

Abstract
In this single-center study, we retrospectively analyzed incidence and risk factors for hepatic veno-occlusive disease (VOD) in 249 consecutive patients who underwent allogeneic hematopoietic stem cell transplantation between January 1990 and June 1995. Twenty-four of the 249 transplanted patients developed VOD. The probabilities of developing VOD were 17% among women and 7% in men (P =.01). In women treated with norethisterone, the incidence was 27% compared with 3% in women without this treatment (P =.007). One-year survival rates were 17% and 73% in patients with (n = 24) or without VOD (n = 225), respectively. The use of heparin prophylaxis (100 IE/kg/24 hours for 1 month) did not alter the incidence or 1-year mortality of VOD. In multivariate analysis, the following risk factors were significant: norethisterone treatment (P <.001), bilirubin >26 micromol/L before bone marrow transplantation (BMT) (P =.002), one HLA-antigen mismatch (P =.003), previous abdominal irradiation (P =.02), and conditioning with busulphan (P =.02). Our conclusion is that norethisterone treatment should not be used in patients undergoing BMT and heparin prophylaxis did not affect the incidence or mortality of VOD.
AuthorsH Hägglund, M Remberger, S Klaesson, B Lönnqvist, P Ljungman, O Ringdén
JournalBlood (Blood) Vol. 92 Issue 12 Pg. 4568-72 (Dec 15 1998) ISSN: 0006-4971 [Print] United States
PMID9845522 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Heparin
  • Norethindrone
Topics
  • Adolescent
  • Adult
  • Bone Marrow Transplantation (adverse effects)
  • Child
  • Child, Preschool
  • Female
  • Hematopoietic Stem Cell Transplantation (adverse effects)
  • Heparin (therapeutic use)
  • Hepatic Veno-Occlusive Disease (chemically induced, epidemiology, prevention & control)
  • Humans
  • Incidence
  • Infant
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Norethindrone (adverse effects)
  • Retrospective Studies
  • Risk Factors
  • Survival Rate

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