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Hepatic dysfunction following busulfan and cyclophosphamide myeloablation: a retrospective, multicenter analysis
M J Styler1, P Crilley, J Biggs
1Department of Neoplastic Diseases, Hahnemann University Hospital, Philadelphia, PA 19102, USA.
Bone Marrow Transplantation
|July 1, 1996
Summary
Veno-occlusive disease (VOD) affects 27% of bone marrow transplant patients. Identifying risk factors like elevated enzymes and specific medications can help prevent severe VOD and reduce transplant-related mortality.
Area of Science:
- Hematology
- Oncology
- Transplantation Medicine
Background:
- Veno-occlusive disease (VOD) is a major complication after bone marrow transplantation (BMT).
- Severe VOD significantly increases patient morbidity and early mortality.
- Understanding VOD risk factors is crucial for improving BMT outcomes.
Purpose of the Study:
- To determine the incidence of VOD after BMT.
- To identify risk factors associated with severe VOD.
- To evaluate the impact of VOD severity on patient mortality.
Main Methods:
- Retrospective analysis of 350 patients undergoing BMT.
- Patients received a preparative regimen of busulfan and cyclophosphamide.
- VOD incidence and severity assessed using McDonald criteria; risk factors analyzed via multivariate analysis.
Main Results:
- Overall VOD incidence was 27% (11% mild, 5% moderate, 11% severe).
- Risk factors for severe VOD included elevated pretransplant transaminases and alkaline phosphatase, ciprofloxacin, estrogen/progestins, vancomycin, and methotrexate.
- Severe VOD was associated with significantly higher mortality (31%) compared to mild/moderate VOD.
Conclusions:
- Risk factors for VOD are regimen-dependent.
- Specific patient and treatment factors predict severe VOD development.
- Identifying high-risk patients allows for targeted VOD prevention strategies.