Contributions
Abstract: PB2427
Type: Publication Only
Background
Sinusoidal obstruction syndrome/veno-occlusive disease of the liver (SOS/VOD) has been a common and potentially life-threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT).
Aims
To study the effect of busulfan dose adjustment during conditioning prior to HSCT on the patients' risk for developing SOS/VOD and the clinical outcome.
Methods
We focused on patients undergoing myeloablative conditioning with oral busulfan (16 mg/kg) and cyclophosphamide (120 mg/kg) (Bu-Cy) before allogeneic HSCT during 1990-2015. Since the end of 1990’s dose adjustment based on pharmacokinetic analysis has been performed for busulfan. Norethisterone therapy was discontinued in 1998. Most patients had a hematological malignancy. Median age was 34 years (<1-61). A matched related donor was used in 164 patients, a matched unrelated donor was in 166 and a mismatched donor was in 42 patients. Stem cell source was bone marrow (BM) (n=157), peripheral blood stem cells (PBSC) (n=195) and cord blood (CB) (n=20). The majority of patients received cyclosporine and methotrexate as GVHD prophylaxis. SOS was diagnosed according to the Baltimore criteria.
Results
SOS/VOD of the liver was diagnosed in 26 patients (7.0%). Patients receiving PBSC had a SOS/VOD incidence of 3.1% compared to 10.8% and 15.0% in patients given BM and CB, respectively (P=0.006). The incidence of SOS/VOD decreased gradually over time with the highest incidence 1995-99, 14.7% compared to 2.3% during 2010-2014. In multivariate analysis, use of PBSC (P=0.01) and patients in CR1/CP1 (P=0.027) was protective. Overall survival at one year was 46% vs. 77% in patients with or without SOS/VOD (P<0.001).
Conclusion
With appropriate management steps the incidence of SOS/VOD may be decreased.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Busulfan, Cyclophosphamide, Stem cell transplant, VOD
Abstract: PB2427
Type: Publication Only
Background
Sinusoidal obstruction syndrome/veno-occlusive disease of the liver (SOS/VOD) has been a common and potentially life-threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT).
Aims
To study the effect of busulfan dose adjustment during conditioning prior to HSCT on the patients' risk for developing SOS/VOD and the clinical outcome.
Methods
We focused on patients undergoing myeloablative conditioning with oral busulfan (16 mg/kg) and cyclophosphamide (120 mg/kg) (Bu-Cy) before allogeneic HSCT during 1990-2015. Since the end of 1990’s dose adjustment based on pharmacokinetic analysis has been performed for busulfan. Norethisterone therapy was discontinued in 1998. Most patients had a hematological malignancy. Median age was 34 years (<1-61). A matched related donor was used in 164 patients, a matched unrelated donor was in 166 and a mismatched donor was in 42 patients. Stem cell source was bone marrow (BM) (n=157), peripheral blood stem cells (PBSC) (n=195) and cord blood (CB) (n=20). The majority of patients received cyclosporine and methotrexate as GVHD prophylaxis. SOS was diagnosed according to the Baltimore criteria.
Results
SOS/VOD of the liver was diagnosed in 26 patients (7.0%). Patients receiving PBSC had a SOS/VOD incidence of 3.1% compared to 10.8% and 15.0% in patients given BM and CB, respectively (P=0.006). The incidence of SOS/VOD decreased gradually over time with the highest incidence 1995-99, 14.7% compared to 2.3% during 2010-2014. In multivariate analysis, use of PBSC (P=0.01) and patients in CR1/CP1 (P=0.027) was protective. Overall survival at one year was 46% vs. 77% in patients with or without SOS/VOD (P<0.001).
Conclusion
With appropriate management steps the incidence of SOS/VOD may be decreased.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Busulfan, Cyclophosphamide, Stem cell transplant, VOD