Results of fractionated TBI prior to bone marrow transplantation in standard risk leukaemia at Marseille

Resbeut, M.; Altschuler, C; Blaise, Didier; Maraninchi, D; Stoppa, Anne Marie; Guillet, J G; Carcassonne, Y

doi:10.1016/0167-8140(90)90193-z

Cited by 1 publication

(1 citation statement)

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“…For example, lower incidences of VOD and other transplantation-related complications have been reported with the use of reduced-intensity conditioning (RIC) protocols [88,91], i.v. or targeted busulfan (dose-adjusted according to individual patient pharmacokinetics) [72,92–94], T cell depletion [62,65,88,89,92,95], and fractionation of the TBI dose used for SCT conditioning [96–100]. It is known that fewer SCT complications arise when HLA-matched siblings are used as donors [98,101–103], and in the last decade, the advent of high-resolution HLA typing has led to a significantly reduced complication rate and improved outcome for SCT patients overall [104].…”

Section: Discussionmentioning

confidence: 99%

Hepatic Veno-Occlusive Disease following Stem Cell Transplantation: Incidence, Clinical Course, and Outcome

Coppell

Richardson

Soiffer

et al. 2010

Biology of Blood and Marrow Transplantation

532

550

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The occurrence of hepatic veno-occlusive disease (VOD) has been reported in up to 60% of patients following stem cell transplantation (SCT), with incidence varying widely between studies depending on the type of transplant, conditioning regimen, and criteria used to make the diagnosis. Severe VOD is characterized by high mortality and progression to multiorgan failure (MOF); however, there is no consensus on how to evaluate severity. This review and analysis of published reports attempts to clarify these issues by calculating the overall mean incidence of VOD and mortality from severe VOD, examining the effect of changes in SCT practice on the incidence of VOD over time, and discussing the methods used to evaluate severity. Across 135 studies performed between 1979 and October 2007, the overall mean incidence of VOD was 13.7% (95% confidence interval [CI] = 13.3%–14.1%). The mean incidence of VOD was significantly lower between 1979–1994 than between 1994–2007 (11.5% [95% CI, 10.9%–12.1%] vs 14.6% [95% CI, 14.0%–15.2%]; P < .05). The mortality rate from severe VOD was 84.3% (95% CI, 79.6%–88.9%); most of these patients had MOF, which also was the most frequent cause of death. Thus, VOD is less common than early reports suggested, but the current incidence appears to be relatively stable despite recent advances in SCT, including the advent of reduced-intensity conditioning. The evolution of MOF in the setting of VOD after SCT can be considered a reliable indication of severity and a predictor of poor outcome.

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