BACKGROUND: Hepatic veno-occlusive disease (VOD) is one of the most serious complications in stem cell transplantation (SCT). Although plasma protein C activity decreases in VOD after SCT, the timeframe of plasma protein C activity decreases during SCT is not known. PROCEDURE: We examined levels of plasma protein C serially during the course of SCT to determine the critical level and risk factors for VOD. RESULTS: Of 151 children who received SCT, 12 of them (7.9%) developed VOD. The mean minimum protein C activity in patients with VOD was significantly lower compared to that in patients without VOD (P < 0.0001). Receiver operating characteristic curve analysis revealed that the critical plasma protein C activity (cut-off point) for VOD was identified to be 34.5% with high sensitivity (100%) and specificity (83.3%), and the reduction of plasma protein C below the cut-off level (day +6.50 +/- 2.43) was observed mostly prior to the onset of VOD (day +7.33 +/- 2.64). The patients receiving melphalan in conditioning were found to be at high risk for VOD (P = 0.003). Among the melphalan containing regimens, melphalan + carboplatin + etoposide was a significant risk factor for depression of plasma protein C (P = 0.037). CONCLUSION: Plasma protein C level was a useful parameter of VOD after SCT, and activity below 34.5% was critical for VOD. The use of melphalan in conditioning causes a high risk for VOD. Copyright 2009 Wiley-Liss, Inc.
BACKGROUND:Hepatic veno-occlusive disease (VOD) is one of the most serious complications in stem cell transplantation (SCT). Although plasma protein C activity decreases in VOD after SCT, the timeframe of plasma protein C activity decreases during SCT is not known. PROCEDURE: We examined levels of plasma protein C serially during the course of SCT to determine the critical level and risk factors for VOD. RESULTS: Of 151 children who received SCT, 12 of them (7.9%) developed VOD. The mean minimum protein C activity in patients with VOD was significantly lower compared to that in patients without VOD (P < 0.0001). Receiver operating characteristic curve analysis revealed that the critical plasma protein C activity (cut-off point) for VOD was identified to be 34.5% with high sensitivity (100%) and specificity (83.3%), and the reduction of plasma protein C below the cut-off level (day +6.50 +/- 2.43) was observed mostly prior to the onset of VOD (day +7.33 +/- 2.64). The patients receiving melphalan in conditioning were found to be at high risk for VOD (P = 0.003). Among the melphalan containing regimens, melphalan + carboplatin + etoposide was a significant risk factor for depression of plasma protein C (P = 0.037). CONCLUSION: Plasma protein C level was a useful parameter of VOD after SCT, and activity below 34.5% was critical for VOD. The use of melphalan in conditioning causes a high risk for VOD. Copyright 2009 Wiley-Liss, Inc.
Authors: A Iguchi; N Kawamura; R Kobayashi; S-I Takezaki; Y Ohkura; J Inamoto; J Ohshima; M Ichikawa; T Sato; M Kaneda; Y Cho; M Yamada; I Kobayashi; T Ariga Journal: Bone Marrow Transplant Date: 2011-01-24 Impact factor: 5.483
Authors: S Corbacioglu; E Carreras; M Ansari; A Balduzzi; S Cesaro; J-H Dalle; F Dignan; B Gibson; T Guengoer; B Gruhn; A Lankester; F Locatelli; A Pagliuca; C Peters; P G Richardson; A S Schulz; P Sedlacek; J Stein; K-W Sykora; J Toporski; E Trigoso; K Vetteranta; J Wachowiak; E Wallhult; R Wynn; I Yaniv; A Yesilipek; M Mohty; P Bader Journal: Bone Marrow Transplant Date: 2017-07-31 Impact factor: 5.483