Linked Life Data

10534061

Source:http://linkedlifedata.com/resource/pubmed/id/10534061

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
1999-11-24
pubmed:abstractText
The purpose of this study was to determine the incidence of veno-occlusive disease (VOD) after a high-dose regimen of busulfan, melphalan, and thiotepa and the risk factors for a more severe outcome. We followed 253 consecutive patients with malignant disorders who received autologous transplants after stem cell harvest followed by 12 mg/kg busulfan, 100 mg/m2 melphalan, and 500 mg/m2 thiotepa. Diagnosis of VOD was based on weight gain, hepatomegaly, and jaundice. Risk factors for moderate or severe VOD were identified using logistic regression models. VOD occurred in 70 of 253 patients (28%), of whom 31 (12%) had moderate and 11 (4%) severe VOD. The median day of onset of hyperbilirubinemia was day 9, significantly later than the onset of jaundice after our cyclophosphamide-based regimens (p < 0.001). Resolution of weight gain and jaundice, followed by their reappearance several weeks later, occurred in 23 of 70 patients with VOD and was an adverse prognostic sign. Risk factors for moderate or severe VOD were a diagnosis of lymphoma or myeloma (odds ratio [OR] 2.65 compared with breast cancer), tumor involvement in the liver (OR 3.95), fever in the month before transplant (OR 3.32), and prior radiation therapy (OR 2.70). We conclude that VOD after busulfan, melphalan, and thiotepa was less frequent and less severe and developed later than VOD after our historical cyclophosphamide-based regimens. Significant risk factors included a diagnosis other than breast cancer, hepatic metastases, persistent fever, and prior radiation therapy. This study suggests that alkylating agents of comparable overall toxicity differ in their liver toxicity.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1083-8791
pubmed:author
pubmed:issnType
Print
pubmed:volume
5
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
306-15
pubmed:dateRevised
2007-11-14
pubmed:meshHeading
pubmed-meshheading:10534061-Adolescent, pubmed-meshheading:10534061-Adult, pubmed-meshheading:10534061-Aged, pubmed-meshheading:10534061-Antineoplastic Agents, Alkylating, pubmed-meshheading:10534061-Busulfan, pubmed-meshheading:10534061-Child, pubmed-meshheading:10534061-Child, Preschool, pubmed-meshheading:10534061-Cyclophosphamide, pubmed-meshheading:10534061-Female, pubmed-meshheading:10534061-Hematologic Neoplasms, pubmed-meshheading:10534061-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:10534061-Hepatic Veno-Occlusive Disease, pubmed-meshheading:10534061-Humans, pubmed-meshheading:10534061-Incidence, pubmed-meshheading:10534061-Liver Diseases, pubmed-meshheading:10534061-Male, pubmed-meshheading:10534061-Melphalan, pubmed-meshheading:10534061-Middle Aged, pubmed-meshheading:10534061-Multiple Organ Failure, pubmed-meshheading:10534061-Multivariate Analysis, pubmed-meshheading:10534061-Radiotherapy, pubmed-meshheading:10534061-Risk Factors, pubmed-meshheading:10534061-Survival Rate, pubmed-meshheading:10534061-Thiotepa, pubmed-meshheading:10534061-Transplantation, Autologous, pubmed-meshheading:10534061-Transplantation Conditioning, pubmed-meshheading:10534061-Treatment Outcome, pubmed-meshheading:10534061-Whole-Body Irradiation
pubmed:year
1999
pubmed:articleTitle
Veno-occlusive disease of the liver after busulfan, melphalan, and thiotepa conditioning therapy: incidence, risk factors, and outcome.
pubmed:affiliation
Gastroenterology/Hepatology Section, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA.
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Research Support, U.S. Gov't, P.H.S., Research Support, Non-U.S. Gov't