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Danaparoid as the prophylaxis for hepatic veno‐occlusive disease after allogeneic hematopoietic stem cell transplantation in childhood hematological malignancy
Author(s) -
Sakaguchi Hirotoshi,
Watanabe Nobuhiro,
Muramatsu Hideki,
Doisaki Sayoko,
Yoshida Nao,
Matsumoto Kimikazu,
Kato Koji
Publication year - 2010
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22645
Subject(s) - medicine , hematopoietic stem cell transplantation , hepatic veno occlusive disease , transplantation , malignancy , stem cell , hematopoietic cell , haematopoiesis , disease , hematological malignancy , oncology , biology , genetics
Background Veno‐occlusive disease (VOD) is a regimen‐related toxicity that occurs in the early phase of hematopoietic stem cell transplantation (HSCT). Therapeutic modalities for established VOD are limited, and severe VOD characterized by multiple organ failure is associated with a fatal prognosis despite intensive supportive care. Procedure We analyzed the data of 95 consecutive allogeneic HSCT for childhood hematological malignancies, and assessed the efficacy of our VOD prophylaxis regimen based on danaparoid (n = 48), comparing with historical control regimen based on dalteparin (n = 47). Results Eight patients (danaparoid cohort in one; dalteparin cohort in seven) developed VOD on day +30 (median onset, day +22; range, day +11 to day +28) after HSCT. The probability of developing VOD for the danaparoid cohort was 2% (95% CI, 0–6%) and that of the dalteparin cohort was 15% (95% CI, 5–26%). In the Cox hazard proportional model, the danaparoid cohort had a significant advantage over the dalteparin cohort for the prophylaxis of VOD (hazard ratio (HR), 0.0; 95% CI, 0.0–0.3; P < 0.01) without increasing hemorrhagic events. Conclusions Our findings suggest that danaparoid may have promise for the prophylaxis of VOD after allogeneic HSCT and further randomized studies are warranted. Pediatr Blood Cancer. 2010;55:1118–1125. © 2010 Wiley‐Liss, Inc.