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Risk factors for hepatic veno-occlusive disease: a retrospective unicentric study in 116 children autografted after a

A Cacchione1, A LeMaitre, D Valteau Couanet

  • 1Department of Pediatrics, Institut Gustave Roussy, Villejuif, France. antonellacacchione@katamail.com

Bone Marrow Transplantation
|July 1, 2008
PubMed

Insights

Previous carboplatin therapy increases the risk of hepatic veno-occlusive disease (HVOD) in pediatric brain tumor patients undergoing autologous hematopoietic stem cell transplant (AHSCT) with a BU-thiotepa (BU-TTP) regimen. This finding aids in identifying high-risk patients.

Area of Science:

  • Pediatric Hematology-Oncology
  • Stem Cell Transplantation
  • Clinical Research

Background:

  • Hepatic veno-occlusive disease (HVOD) incidence is rising in pediatric patients receiving BU-thiotepa (BU-TTP) conditioning.
  • Understanding risk factors for HVOD is crucial for improving transplant outcomes.

Purpose of the Study:

  • To identify risk factors contributing to the increased incidence of HVOD.
  • To analyze demographic, clinical, biological, and therapeutic parameters associated with HVOD.

Main Methods:

  • Retrospective analysis of 116 pediatric patients treated with BU-TTP and AHSCT.
  • Evaluation of risk factors using uni- and multivariate analyses.
  • Diagnosis of HVOD based on McDonald's clinical criteria.

Main Results:

  • HVOD was diagnosed in 31% of the studied pediatric patients.
  • Previous carboplatin therapy (P=0.028) and etoposide (P=0.048) significantly correlated with increased HVOD risk.
  • HVOD was associated with a higher risk of post-transplant death due to organ failure (P=0.029).

Conclusions:

  • Prior carboplatin administration in conventional chemotherapy is a significant risk factor for developing HVOD.
  • This risk is particularly relevant for brain tumor patients undergoing BU-TTP consolidation and AHSCT.
  • Identifying these risk factors can inform preventative strategies and patient management.

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