Summary:therefore determined the incidence of VOD using the McDonald's criteria and analyzed the clinical characteristics of patients with VOD and those without it. One hundred and thirty-seven consecutive patients who received bone marrow or peripheral blood stem cell transplantation were studied retrospectively to identify the risk factors for hepatic veno-occlusive disease Materials and methods (VOD). Of the 137 recipients, twenty (14.6%) patients were diagnosed with VOD using the McDonald's criPatients teria. In these 20 patients with VOD, we analyzed various clinical parameters, including age, sex, HLA status, One hundred and thirty-seven consecutive patients (52 conditioning regimen, irradiation, immunosuppressive males and 85 females) underwent bone marrow transplanagents, mode of transplantation, history of hepatic dystation (including peripheral blood transplantation) for function, pre-transplant hepatic and renal function, hematological malignancies and severe aplastic anemia at infectious episodes, antibiotics use, and serum viral titour institution between September 1989 and October 1995. ers. A history of hepatic dysfunction and low levels ofThe average age of patients was 29.9 (6-51) years old. pseudocholinesterase before transplantation were found to be statistically significant (P = 0.04 and 0.04). LowConditioning regimens and graft-versus-host disease levels of pseudocholinesterase were significant by multi-(GVHD) prophylaxis variate analysis using the logistic regression model (P = 0.02). These results suggest that pseudocholinester-The primary disease for which transplantation was carried ase levels before transplant are important markers of out, transplantation procedures and immunosuppressive VOD in patients receiving BMT.agents used are summarized in Table 1.

We describe the case of a 51-year-old patient with relapsed myelodysplastic syndrome after allogeneic bone marrow transplantation (BMT), who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) after conditioning with a novel regimen consisting of fludarabine, busulfan, and antithymocyte globulin. The second PBSCT was performed early, at 3 months after the initial allogeneic BMT, but it was well tolerated and complete hematologic remission was documented. The patient did not experience any early transplantation-related organ toxicity but died from opportunistic infection 6 months after the second transplantation. Our experience suggests that this novel regimen may induce remission and could be offered to patients relapsing after the first transplantation; however, the fludarabine-containing regimen might be accompanied by profound immunosuppression.