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Annals of Hematology

, Volume 98, Issue 3, pp 745–752 | Cite as

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

  • Chien-Chang Lee
  • Hsiu-Hao ChangEmail author
  • Meng-Yao Lu
  • Yung-Li Yang
  • Shu-Wei Chou
  • Dong-Tsamn Lin
  • Shiann-Tarng Jou
  • Ming Yao
  • Chi-Cheng Li
  • Su-Peng Yeh
  • Mei-Hui Chen
  • Jyh-Pyng Gau
  • Sin-Syue Li
  • Po-Nan Wang
  • Yi-Chang Liu
  • Tso-Fu Wang
  • Tran-Der Tan
  • Ming-Yang Lee
  • Ming-Sun Yu
  • Chuan-Cheng Wang
  • Shih-Chiang Lin
  • Yeu-Chin Chen
  • Yung-Cheng Su
  • Ko-Ying Su
  • Kai-Hsin Lin
Original Article

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.

Keywords

Hematopoietic stem cell transplantation Incidence Risk factors Veno-occlusive disease 

Notes

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.).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Chien-Chang Lee
    • 1
  • Hsiu-Hao Chang
    • 2
    Email author
  • Meng-Yao Lu
    • 2
  • Yung-Li Yang
    • 2
    • 3
  • Shu-Wei Chou
    • 2
  • Dong-Tsamn Lin
    • 2
    • 3
  • Shiann-Tarng Jou
    • 2
  • Ming Yao
    • 4
  • Chi-Cheng Li
    • 5
    • 6
  • Su-Peng Yeh
    • 7
  • Mei-Hui Chen
    • 8
  • Jyh-Pyng Gau
    • 9
  • Sin-Syue Li
    • 10
  • Po-Nan Wang
    • 11
  • Yi-Chang Liu
    • 12
  • Tso-Fu Wang
    • 6
  • Tran-Der Tan
    • 13
  • Ming-Yang Lee
    • 14
  • Ming-Sun Yu
    • 15
  • Chuan-Cheng Wang
    • 16
  • Shih-Chiang Lin
    • 17
  • Yeu-Chin Chen
    • 18
  • Yung-Cheng Su
    • 19
  • Ko-Ying Su
    • 1
  • Kai-Hsin Lin
    • 2
  1. 1.Department of Emergency Medicine, National Taiwan University HospitalNational Taiwan University, College of MedicineTaipeiTaiwan
  2. 2.Department of Pediatrics, National Taiwan University HospitalNational Taiwan University, College of MedicineTaipeiTaiwan
  3. 3.Department of Laboratory Medicine, National Taiwan University HospitalNational Taiwan University, College of MedicineTaipeiTaiwan
  4. 4.Division of Hematology, Department of Internal Medicine, National Taiwan University HospitalNational Taiwan University, College of MedicineTaipeiTaiwan
  5. 5.Tai-Cheng Stem Cell Therapy CenterNational Taiwan University HospitalTaipeiTaiwan
  6. 6.Department of Hematology and OncologyBuddhist Tzu Chi General HospitalHualienTaiwan
  7. 7.Division of Hematology and Oncology, Department of Internal MedicineChina Medical University HospitalTaichungTaiwan
  8. 8.Department of NursingTaichung Veterans General HospitalTaichungTaiwan
  9. 9.Division of Hematology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
  10. 10.Division of Hematology and Oncology, Department of Internal MedicineNational Cheng Kung University HospitalTainanTaiwan
  11. 11.Division of Hematology and Oncology, Department of Internal MedicineChang Gung Medical FoundationTaoyuanTaiwan
  12. 12.Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiungTaiwan
  13. 13.Koo Foundation Sun Yat-Sen Cancer CenterTaipeiTaiwan
  14. 14.Division of Hematology and Oncology, Department of Internal MedicineDitmanson Medical Foundation Chiayi Christian HospitalChiayiTaiwan
  15. 15.Division of Hematology and Oncology, Department of Internal MedicineKaohsiung Veterans General HospitalKaohsiungTaiwan
  16. 16.Division of Medical Oncology in the Hematology-Oncology, Department of Internal MedicineChanghua Christian HospitalChanghuaTaiwan
  17. 17.Division of Medical Oncology and Hematology, Department of Internal MedicineFar Eastern Memorial HospitalNew Taipei CityTaiwan
  18. 18.Division of Hematology and Oncology, Department of MedicineTri-Service General HospitalTaipeiTaiwan
  19. 19.Division of Hematology and Oncology, Department of MedicineTaipei Medical University-Shuang Ho HospitalNew Taipei CityTaiwan

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