Decreased incidence of hepatic veno-occlusive disease and fewer hemostatic derangements associated with intravenous busulfan vs oral busulfan in adults conditioned with busulfan + cyclophosphamide for allogeneic bone marrow transplantation

Lee, Je-Hwan; Choi, Seong-Jun; Lee, Jung-Hee; Kim, So-Eun; Park, Chan-Jeoung; Chi, Hyun-Sook; Lee, Moo-Song; Lee, Jung-Shin; Kim, Woo-Kun; Lee, Kyoo-Hyung
May 2005
Annals of Hematology;May2005, Vol. 84 Issue 5, p321
Academic Journal
We investigated the occurrence of hepatic veno-occlusive disease (VOD) after allogeneic bone marrow transplantation (BMT) in 241 adults conditioned with busulfan + cyclophosphamide at a single institute and retrospectively compared 186 patients who received oral busulfan (O-Bu group) with 55 patients who received intravenous busulfan (I-Bu group). Various hemostatic parameters were determined at baseline and on days 0, 7, 14, and 21. Hepatic VOD occurred in 41.7% of the O-Bu group and in 18.5% of the I-Bu group. Multivariate analysis revealed that the I-Bu group had significantly decreased risk of VOD compared to the O-Bu group [p=0.006, odds ratio: (OR) 0.345]. Eleven patients in the O-Bu group and none of the I-Bu group developed severe VOD. A repeated measures analysis of variance (ANOVA) with a between-subjects factor revealed significant differences in post-transplant levels of antithrombin III, tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), and D-dimer according to the occurrence of VOD. The level of antithrombin III was significantly lower, whereas the level of D-dimer was significantly higher, in the O-Bu group than in the I-Bu group. These findings show that, in adults conditioned with busulfan + cyclophosphamide, intravenous busulfan was associated with significantly decreased incidence of VOD and fewer hemostatic derangements after allogeneic BMT compared to oral busulfan.


Related Articles

  • Antithrombin-III for the treatment of chemotherapy-induced organ dysfunction following bone marrow transplantation. Morris, J D; Harris, R E; Hashmi, R; Sambrano, J E; Gruppo, R A; Becker, A T; Morris, C L // Bone Marrow Transplantation;11/15/97, Vol. 20 Issue 10, p871 

    A hypercoaguable state has been shown to follow high-dose chemotherapy for bone marrow transplantation (BMT). Deficiency of the natural anticoagulants, antithrombin III (AT-III), protein C and protein S correlate with organ dysfunction following BMT. We treated 10 patients with severe post-BMT...

  • Hemostatic Abnormalities Following Bone Marrow Transplantation. Tamaki, Shigehisa; Wada, Hideo; Ohfuzi, Kazuya; Shibata, Takeshi; Masuya, Masahiro; Kageyama, Shinichi; Gabazza, Esteban C.; Kawakami, Keiki; Tsuji, Kohta; Miyanishi, Eiki; Minami, Nobuyuki; Nobori, Tsutomu; Shiku, Hiroshi // Clinical & Applied Thrombosis/Hemostasis;Apr2002, Vol. 8 Issue 2, p125 

    Hemostatic abnormalities in 26 patients following bone marrow transplantation (BMT) were examined. In the event-free survival group, the plasma levels of antithrombin (AT) and protein C (PC) were significantly decreased 1 and 2 weeks after BMT, and the plasma levels of thrombomodulin (TM) and...

  • Relevance of proteins C and S, antithrombin III, von Willebrand factor, and factor VIII for the development of hepatic veno-occlusive disease in patients undergoing allogeneic bone marrow transplantation: a prospective study. Lee, J-H; Lee, K-H; Kim, S; Lee, J-S; Kim, W-K; Park, C-J; Chi, H-S; Kim, S-H // Bone Marrow Transplantation;11/1/98, Vol. 22 Issue 9, p883 

    Factors that enhance hypercoagulability following BMT may have a pathogenetic role in VOD. To investigate the relevance of hemostatic parameters for the development of VOD, we prospectively measured protein C, protein S, antithrombin III (AT III), von Willebrand factor, and factor VIII in 50...

  • Hemostatic Abnormalities and Changes Following Bone Marrow Transplantation. Matsumoto, Takeshi; Wada, Hideo; Nishiyama, Hiroyoshi; Hirano, Tomomi; Sakakura, Miho; Nishii, Kazuhiro; Masuya, Masahiro; Kageyama, Shinichi; Tamaki, Shigehisa; Nakase, Kazunori; Nobori, Tsutomu; Shiku, Hiroshi // Clinical & Applied Thrombosis/Hemostasis;Oct2004, Vol. 10 Issue 4, p341 

    Hemostatic parameters were examined in 39 patients who underwent allogeneic bone marrow transplantation (BMT). Twenty-six patients survived and 13 patients died within 6 months after BMT. The main causes of death were acute graft-versus-host disease (GVHD: n=6), veno-occlusive disease (VOD:...

  • Combination low-dose tissue-type plasminogen activator plus annexin A2 for improving thrombolytic stroke therapy. Yinghua Jiang; Xiang Fan; Zhanyang Yu; Zhengbu Liao; Xiao-Shu Wang; van Leyen, Klaus; Xiaochuan Sun; Lo, Eng H.; Xiaoying Wang; Pugliese, Anna Maria; Kilic, Ertugrul // Frontiers in Cellular Neuroscience;Oct2015, Vol. 9, p1 

    Risk of hemorrhagic transformation, incomplete reperfusion, neurotoxicity, and a short treatment time window comprises major challenges for tissue plasminogen activator (tPA) thrombolytic stroke therapy. Improving tPA therapy has become one of the highest priorities in the stroke field. This...

  • Multiple organ dysfunction syndrome in bone marrow transplantation. Haire, William D.; Ruby, Elizabeth I. // JAMA: Journal of the American Medical Association;10/25/95, Vol. 274 Issue 16, p1289 

    Defines the frequency and outcome of organ dysfunction in bone marrow transplantation (BMT) and determines if patients with organ dysfunction have lower levels of protein C (PC) and/or antithrombin III (ATIII) than those without organ dysfunction. BMT techniques; Adverse outcomes of...

  • Utilizing New Marrow Sources.  // USA Today Magazine;Oct91, Vol. 120 Issue 2557, p10 

    Discusses the benefit of using thawed marrow in bone marrow transplantation. Elimination of a worldwide shortage of marrow needed for victims of leukemia and other blood diseases; Use of an ordinary styrofoam cooler; Role of the marrow as the body's factory for blood and immune cells;...

  • Outcome of patients with low-grade B cell non-Hodgkin lymphoma and initial bone marrow involvement: data of a single institution. Heinz, R.; Hopfinger, G.; Tüchler, H. // Leukemia (08876924);Apr97 Supplement 2, Vol. 11, pS52 

    We evaluated 1179 consecutive patients with low-grade B-NHL diagnosed according to criteria of the Kiel classification and presenting with initial bone marrow involvement. Therapeutic approaches were not changed during the observation period 1975–1995. CLL (n = 895) and IC (n = 169) were...

  • Stroke Alert: A Review of Current Clinical Stroke Literature. Fink, Matthew E. // Neurology Alert;Oct2013, Vol. 32 Issue 2, p12 

    This section presents overviews of research studies on stroke. S. Prabhakaran et al. concluded that pre-hospital triage to primary ischemic stroke centers has improved treatment. A study examined the link of adherence to Mediterranean diet with the risk of stroke, depression, cognitive...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics