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Titolo:
HEPATIC VENOOCCLUSIVE DISEASE FOLLOWING B ONE-MARROW TRANSPLANTATION - PROCEEDINGS OF A SYMPOSIUM OF FAG AND GEGMO GROUPS
Autore:
RIO B; CAHN JY; ATTAL M; DROUET L; SCROBOHACI ML; DEGOS F; DEGOTT C; BEARMAN SI; GRANENA A; BLAISE D; DEVERGIE A; BORDIGONI P; IBRAHIM A; DUSURGET C; GORIN NC; FRANCO D; HARTMAN O; GLUCKMAN E;
Indirizzi:
HOP HOTEL DIEU,SERV HEMATOL,1 PL PARVIS NOTRE DAME F-75181 PARIS 04 FRANCE HOP JEAN MINJOZ,SERV HEMATOL BESANCON FRANCE SERV HEMATOL TOULOUSE FRANCE HOP ST LOUIS,HEMATOL LAB PARIS FRANCE HOP LAENNEC,SERV HEPATOL F-75340 PARIS FRANCE HOP BEAUJON,SERV ANAT PATHOL CLICHY FRANCE FRED HUTCHINSON CANC RES CTR SEATTLE WA 98104 HOP BARCELONE BARCELONA SPAIN INST J PAOLI I CALMETTES F-13009 MARSEILLE FRANCE HOP ST LOUIS,UNITE GREFFE MOELLE PARIS FRANCE CHU NANCY,UNITE GREFE MOELLE VANDOEUVRE NANCY FRANCE INST GUSTAVE ROUSSY VILLEJUIF FRANCE HOP DEBROUSSE,UNITE HEMATOL PEDIAT LYON FRANCE HOP ST ANTOINE,SERV HEMATOL F-75571 PARIS FRANCE HOP ANTOINE BECLERE,SERV CHIRURG CLAMART FRANCE
Titolo Testata:
La Presse medicale
fascicolo: 26, volume: 23, anno: 1994,
pagine: 1217 - 1222
SICI:
0755-4982(1994)23:26<1217:HVDFBO>2.0.ZU;2-1
Fonte:
ISI
Lingua:
FRE
Soggetto:
VENO-OCCLUSIVE DISEASE; HIGH-DOSE CHEMOTHERAPY; VERSUS-HOST DISEASE; VENOCCLUSIVE DISEASE; CONTINUOUS INFUSION; LIVER-DISEASE; SOLID TUMORS; HEPARIN; PREVENTION; COMPLICATIONS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
48
Recensione:
Indirizzi per estratti:
Citazione:
B. Rio et al., "HEPATIC VENOOCCLUSIVE DISEASE FOLLOWING B ONE-MARROW TRANSPLANTATION - PROCEEDINGS OF A SYMPOSIUM OF FAG AND GEGMO GROUPS", La Presse medicale, 23(26), 1994, pp. 1217-1222

Abstract

Hepatic venocclusive disease is a frequent complication after high-dose chemo- or radiotherapy after bone marrow transplantation and is a major cause of mortality. During the 3 weeks following transplantation,acute major hepatic vascularization is observed together with portal hypertension and weight gain, ascitis and oedema of the lower limbs due to non-thrombotic obstruction of the centrilobular hepatic veins. This report summarizes the observations presented at a French symposium of Prance Autogreffe and Groupe d'Etude de la Greffe de Moelle osseuse. Different pathogenic processes are implicated including endothelial mechanisms due to toxic factor related to graft preparations and immunosuppressor treatments (methotrexate, ciclosporin), physical factors related to irradiation, immunological factors related to the expressionof class II antigens on endothelial cells and viral factors, in particular cytomegalovirus infection. The incidence of venocclusive diseasevaries greatly from one series to another. Two French groups reported5 and 3 cases among 1991 and 253 autologous grafts respectively (1.2 and 2.3%) while the Seattle group observed 53% among 355 consecutive grafts, although the same clinical criteria were used. Histological criteria include fibrosis around a non-thrombotic occlusion of the centrilobular veins, cytolysis and congestion of the sinuses. Other methods for diagnosis include transjugular biopsy, the suprahepatic pressure and imaging techniques. Prophylactic continuous infusion of low-dose heparin has been associated with a lower incidence. Trials using anti-tumour necrosis drugs and prostaglandin E1 have also been undertaken andshow possible effects towards decreasing prevalence. To date treatment still relies on symptomatic control of body fluid distribution and maintenance of renal blood flow. Trials with prostaglandin E1 and recombinant tissue plasminogen activator as curative treatment are currently debated and require further study before their effectiveness can be determined.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 09:45:35