ABSTRACT
PURPOSE: In this study we tested the hypothesis that vasodilatation and antithrombogenic effect in damaged vessels using low-dose Lipo PGE1 might result in increased sinusoidal blood flow and in decreased obstruction and minimize the incidence or severity of hepatic veno-occlusive disease (VOD). METHPDS: Children underwent hematopoietic stem cell transplantation for hematologic malignancies were enrolled in this study. Lipo PGE1 was begun one day prior to the start of conditioning to day 30 after stem cell transplantation in continuous intravenous infusion at a dose of 1 mug/kg/day (0.042 mug/ kg/hr). We evaluate the incidence and severity of hepatic VOD and the toxicity of Lipo PGE1. RESULTS: From November 1999 to Jun 2000, 20 patients (M:F=15:5, median age 5 years) underwent hematopoietic stem cell (5 matched sibling bone marrow, 4 autologous bone marrow, 8 unrelated bone marrow, 3 unrelated cord blood) transplantation for hematologic malignancies (9 ALL, 8 AML, 3 CML) were enrolled in this study. There was no occurrence of VOD within 30 day of transplant. Only one out of 20 patients was diagnosed as delayed VOD, easily controlled moderate form, on post-transplant day 58. There was no toxicity attributed to Lipo PGE1. CONCLUSION: This study suggests that prophylactic low-dose Lipo PGE1 treatment may decrease the incidence of VOD in patients treated for hematologic malignancies by hematopoietic stem cell transplantation.