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The incidence and risk factors of hepatic veno-occlusive disease after hematopoietic stem cell transplantation in Taiwan

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Abstract

Hepatic veno-occlusive disease (VOD) is a potentially fatal complication of hematopoietic stem cell transplantation (HSCT). We conducted this study to investigate the incidence and risk factors of hepatic VOD for patients receiving HSCT in Taiwan. We retrospectively analyzed the data from a nationwide registry for patients receiving HSCT, which was collected by the Taiwan Society of Blood and Marrow Transplantation. The data collection period was from 2009 to 2014. A total 2345 patients were reviewed and 39 patients among them were diagnosed as having hepatic VOD. The cumulative incidence of hepatic VOD in the whole cohort of 2345 patients was 1.66%. In multivariate analysis, disease diagnosis of myelodysplastic syndrome, chronic HCV infection, condition regimens of bulsulfan intravenously administered, and antithymocyte immunoglobulin were independent factors to predict higher risk of hepatic VOD. The overall mortality rate for patients with hepatic VOD was 79%. Patients with hepatic VOD had significant worse survival outcomes when compared with those without hepatic VOD (P = 0.00063). In conclusion, although the incidence is low, hepatic VOD remains a serious complication after HSCT in Taiwan. The findings of this study could be the basis for developing prophylactic or early treatment strategies for hepatic VOD.

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Acknowledgments

The authors thank all the patients and hospitals who participated in this study. The authors acknowledge the Taiwan Society of Blood and Marrow Transplantation for data collection and registry. The authors also wish to thank Mrs. Bor-Yu Tsai and Shin-Tsung Huang from the NAVI Biotherapeutics Inc. (Taiwan) for supports in data analysis and advice.

Funding

This work was supported by grants from the National Taiwan University Hospital (NTUH 107-S3777, 108-S4194 to H.-H. C.) and Ministry of Science and Technology, Taiwan (MOST 103-2314-B-002-072 and 104–2314-B-002-168-MY3, to H.-H. C.).

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Authors and Affiliations

  1. Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan

    Chien-Chang Lee & Ko-Ying Su

  2. Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, College of Medicine, No. 8 Chung-Shan South Road, Taipei, 10041, Taiwan

    Hsiu-Hao Chang, Meng-Yao Lu, Yung-Li Yang, Shu-Wei Chou, Dong-Tsamn Lin, Shiann-Tarng Jou & Kai-Hsin Lin

  3. Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan

    Yung-Li Yang & Dong-Tsamn Lin

  4. Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan

    Ming Yao

  5. Tai-Cheng Stem Cell Therapy Center, National Taiwan University Hospital, Taipei, Taiwan

    Chi-Cheng Li

  6. Department of Hematology and Oncology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

    Chi-Cheng Li & Tso-Fu Wang

  7. Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan

    Su-Peng Yeh

  8. Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan

    Mei-Hui Chen

  9. Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Jyh-Pyng Gau

  10. Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan

    Sin-Syue Li

  11. Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Medical Foundation, Linkou Branch, Taoyuan, Taiwan

    Po-Nan Wang

  12. Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yi-Chang Liu

  13. Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan

    Tran-Der Tan

  14. Division of Hematology and Oncology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan

    Ming-Yang Lee

  15. Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Ming-Sun Yu

  16. Division of Medical Oncology in the Hematology-Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan

    Chuan-Cheng Wang

  17. Division of Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan

    Shih-Chiang Lin

  18. Division of Hematology and Oncology, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan

    Yeu-Chin Chen

  19. Division of Hematology and Oncology, Department of Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan

    Yung-Cheng Su

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  1. Chien-Chang Lee
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  8. Ming Yao
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  13. Sin-Syue Li
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  18. Ming-Yang Lee
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Correspondence to Hsiu-Hao Chang.

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Lee, CC., Chang, HH., Lu, MY. et al. The incidence and risk factors of hepatic veno-occlusive disease after hematopoietic stem cell transplantation in Taiwan. Ann Hematol 98, 745–752 (2019). https://doi.org/10.1007/s00277-019-03604-2

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