Late-Onset Hepatic Veno-Occlusive Disease after Allografting: Report of Two Cases with Atypical Clinical Features Successfully Treated with Defibrotide.

Mediterr J Hematol Infect Dis 2018 1;10(1):e2018001. Epub 2018 Jan 1.

A.O.U. Città della Salute e della Scienza di Torino, Dipartimento di Oncologia, SSD Trapianto allogenico di cellule staminali, Torino, Italy.

Hepatic Veno-Occlusive Disease (VOD) is a potentially severe complication of hematopoietic stem cell transplantation (HSCT). Here we report two patients receiving an allogeneic HSCT who developed late onset VOD with atypical clinical features. The two patients presented with only few risk factors, namely, advanced acute leukemia, a myeloablative busulphan-containing regimen and received grafts from an unrelated donor. The first patient did not experience painful hepatomegaly and weight gain and both patients showed only a mild elevation in total serum bilirubin level. Most importantly, the two patients developed clinical signs beyond day 21 post-HSCT. Hepatic transjugular biopsy confirmed the diagnosis of VOD. Intravenous defibrotide was promptly started leading to a marked clinical improvement. Based on our experience, liver biopsy may represent a useful diagnostic tool when the clinical features of VOD are ambiguous. Early therapeutic intervention with defibrotide represents a crucial issue for the successful outcome of patients with VOD.

Download full-text PDF

Source
http://dx.doi.org/10.4084/MJHID.2018.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5760078PMC
January 2018
46 Reads

Publication Analysis

Top Keywords

clinical features
12
veno-occlusive disease
8
hepatic veno-occlusive
8
atypical clinical
8
vod
5
clinical
5
patients
5
experience liver
4
hepatomegaly weight
4
unrelated donor
4
weight gain
4
represent diagnostic
4
donor patient
4
patient experience
4
experience painful
4
grafts unrelated
4
biopsy represent
4
liver biopsy
4
painful hepatomegaly
4
diagnostic tool
4

Similar Publications