Hepatic complications of hematopoietic cell transplantation

Levitsky, Josh; Sorrell, Michael F.

doi:10.1007/s11894-008-0022-y

Cited by 26 publications

(13 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We hypothesize that the patient’s previous systemic therapy and transplant may have resulted in subclinical liver injury, and the additional radiation injury from SBRT depleted what remained of the patient’s already diminished hepatic reserve, enough to cause fulminant liver failure. Indeed, altered liver function is a common complication of stem cell transplantation, with complications ranging from increased liver function enzymes to graft-versus-host disease, hepatic veno-occlusive disease, and death due to liver failure [22]. Interestingly, at the time of liver failure the patient had no evidence of active disease, neither cholangiocarcinoma nor breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes and toxicity using Stereotactic Body Radiotherapy (SBRT) for advanced cholangiocarcinoma

et al. 2012

View full text Add to dashboard Cite

BackgroundTo report single-institutional clinical outcomes and toxicity with SBRT for cholangiocarcinoma.MethodsFrom March 2009 to July 2011, 10 patients with 12 unresectable primary (n = 6) or recurrent (n = 6) cholangiocarcinoma lesions underwent abdominal SBRT. Sites treated included liver (n = 10), abdominal lymph nodes (n = 1), and adrenal gland (n = 1). SBRT was delivered in three (n = 2) or five (n = 10) consecutive daily fractions over one week. The median prescription dose was 55 Gy (range, 45–60). Treatment response was graded by RECIST v.1.1, and toxicities were scored by CTCAE v.4.0. Data was analyzed using the Kaplan-Meier method to determine rates of local control (LC), freedom from distant progression (FFDM) and overall survival (OS).ResultsThe median follow-up was 14 months (range, 2–26 months). LC, defined as freedom from progression within the SBRT field, was 100%, but four patients treated to intrahepatic sites experienced progression elsewhere in the liver. Estimates for FFDM at 6 and 12 months were 73% and 31%, respectively. Sites of disease relapse included liver (n = 3), liver and lymph nodes (n = 1), liver and lungs (n = 1), lymph nodes (n = 1), and mesentery (n = 1). OS estimates for the cohort at 6 and 12 months were 83% and 73%, respectively. The most common Grade ≥2 early toxicities were Grade 2 nausea and vomiting (n = 5) and gastrointestinal pain (n = 2). Late ≥2 toxicities included Grade 2 gastrointestinal pain (n = 3), Grade 3 biliary stenosis (n = 1), and Grade 5 liver failure (n = 1).ConclusionsSBRT shows promise as an effective local therapy for properly-selected patients with cholangiocarcinoma. Further follow-up is needed to better quantify the risk of late complications associated with SBRT.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical outcomes and toxicity using Stereotactic Body Radiotherapy (SBRT) for advanced cholangiocarcinoma

et al. 2012

View full text Add to dashboard Cite

show abstract

“…SOS, previously known as hepatic veno-occlusive disease, was most commonly reported to occur after bone marrow transplantation for hematologic malignancies [ 11 ]. SOS has been reported in 19%-79% of CRC patients who underwent hepatic resection after oxaliplatin-based chemotherapy [ 6 , 7 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Splenomegaly and Its Associations with Genetic Polymorphisms and Treatment Outcome in Colorectal Cancer Patients Treated with Adjuvant FOLFOX

et al. 2016

View full text Add to dashboard Cite

PurposeSplenomegaly is a clinical surrogate of oxaliplatin-induced sinusoidal obstruction syndrome (SOS). We investigated development of splenomegaly and its association with treatment outcome and genetic polymorphisms following adjuvant 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) in colorectal cancer (CRC) patients.Materials and MethodsSplenomegaly was determined by spleen volumetry using computed tomography images obtained before initiation of chemotherapy and after completion of adjuvant FOLFOX in CRC patients. Ten genetic polymorphisms in 4 SOS-related genes (VEGFA, MMP9, NOS3, and GSTP1) were analyzed using DNA from peripheral blood mononuclear cells.ResultsOf 124 patients included, increase in spleen size was observed in 109 (87.9%). Median change was 31% (range, –42% to 168%). Patients with splenomegaly had more severe thrombocytopenia compared to patients without splenomegaly during the chemotherapy period (p < 0.0001). The cumulative dose of oxaliplatin and the lowest platelet count during the chemotherapy period were clinical factors associated with splenomegaly. However, no significant associations were found between genetic polymorphisms and development of splenomegaly. Disease-free survival was similar regardless of the development of splenomegaly.ConclusionSplenomegaly was frequently observed in patients receiving adjuvant FOLFOX and resulted in more severe thrombocytopenia but did not influence treatment outcome. Examined genetic polymorphisms did not predict development of splenomegaly.

show abstract

“…In addition, HEV reactivation after HSCT occurred in a patient after allogeneic HSCT who had experienced an episode of acute hepatitis E 2 months before transplantation . In clinical practice, sudden increases of liver transaminases after allogeneic HSCT are not infrequent and are often assumed to be of toxic origin in the context of multiple immunosuppressive and anti‐infective medications . Screening for pathogens causing hepatitis, such as HEV, is not performed on a regular basis in most centers.…”

mentioning

confidence: 99%

Chronic hepatitis E in hematopoietic stem cell transplant patients in a low‐endemic country?

Koenecke

Pischke

Heim

et al. 2011

Transplant Infectious Dis

View full text Add to dashboard Cite

Cases of chronic hepatitis E have been described in patients after kidney and liver transplantation. In addition, hepatitis E virus (HEV) reactivation was reported after hematopoietic stem cell transplantation (HSCT). We here evaluated if HEV infection might explain elevated liver enzymes in a well selected cohort of allogeneic HSCT patients with biochemical evidence of hepatitis (n = 52). Of note, none of the subjects tested positive for HEV RNA, including 2 HSCT patients who had been infected with HEV already before transplantation. Thus, both chronic courses of HEV infections and HEV reactivations seem to be rather rare events in HSCT patients in a non-endemic country.

show abstract

Hepatic complications of hematopoietic cell transplantation

Cited by 26 publications

References 42 publications

Clinical outcomes and toxicity using Stereotactic Body Radiotherapy (SBRT) for advanced cholangiocarcinoma

Clinical outcomes and toxicity using Stereotactic Body Radiotherapy (SBRT) for advanced cholangiocarcinoma

Splenomegaly and Its Associations with Genetic Polymorphisms and Treatment Outcome in Colorectal Cancer Patients Treated with Adjuvant FOLFOX

Chronic hepatitis E in hematopoietic stem cell transplant patients in a low‐endemic country?

Contact Info

Product

Resources

About