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Prophylactic recombinant thrombomodulin treatment prevents hepatic sinusoidal obstruction syndrome in high‐risk pediatric patients that undergo hematopoietic stem cell transplants
Author(s) -
Yamamoto Shohei,
Toyama Daisuke,
Sugishita Yumiko,
Kaneko Ryota,
Okamoto Naoko,
Koganesawa Masaya,
Fujita Sachio,
Akiyama Kosuke,
Matsuno Ryosuke,
Isoyama Keiichi
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13269
Subject(s) - medicine , defibrotide , complication , hematology , hematopoietic stem cell transplantation , hepatic veno occlusive disease , thrombomodulin , surgery , stem cell , gastroenterology , chemoprophylaxis , transplantation , platelet , genetics , biology , thrombin
Hepatic SOS is a potentially life‐threatening complication of conditioning for allogeneic HSCT. rTM is a new drug for treating DIC. We report our experience of the use of rTM as a prophylaxis against SOS in high‐risk pediatric patients that underwent HSCT . We evaluated the cases of 19 pediatric hematology and oncology patients who underwent HSCT at our institution between 2007 and 2016. The patients who received HSCT after 2012 (n = 8) were treated with rTM as a prophylaxis against SOS together with UDCA and LMWH, whereas the others (n = 11) were only treated with UDCA and LMWH . Although SOS occurred by post‐ HSCT day 35 in 3 (27%) patients in the control group, SOS was not seen in the rTM group. Two of the former three patients suffered severe SOS , and one died of the condition. The mean peak level of PAI‐1 (a marker of endothelial damage) was significantly lower in the rTM group. rTM appears to be a safe prophylaxis for SOS . The present findings suggest that prophylactic rTM after HSCT might help to prevent SOS.