Sinusoidal obstruction syndrome/veno-occlusive disease after high-dose intravenous busulfan/melphalan conditioning therapy in high-risk Ewing Sarcoma View Full Text


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Article Info

DATE

2018-01-15

AUTHORS

Massimo Eraldo Abate, Anna Paioli, Sivlia Cammelli, Marilena Cesari, Alessandra Longhi, Emanuela Palmerini, Stefano Ferrari, Elisa Carretta, Piero Picci, Fabio Piscaglia

ABSTRACT

This mono-institutional observational study was conducted to determine incidence, severity, risk factors, and outcome of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) in high-risk Ewing sarcoma (ES) patients treated with intravenous busulfan and melphalan (BU-MEL) followed by autologous stem cell transplantation (ASCT). During the past 10 years, 75 consecutive ES patients resulted evaluable for the analysis. After diagnosis of SOS/VOD, defibrotide therapy was started as soon as the medication was available. The variables analyzed as potential risk factors were: gender, patient's age at diagnosis, primary tumor site, disease stage, and prior radiation therapy (RT) given, focusing on RT liver exposure. The median age at diagnosis was 18.8 years. Five patients developed moderate to severe SOS/VOD (cumulative incidence, 6.67%). None of 32 pediatric patients (≤17 years) developed SOS/VOD (p = 0.0674). In univariate analysis, prior RT liver exposure resulted statistically significant (p = 0.0496). There was one death due to severe SOS/VOD. This study reports the largest series of high-risk ES patients treated with intravenous BU-MEL before ASCT. The incidence of SOS/VOD was lower when compared with other studies that used oral busulfan. Any prior RT liver exposure should be avoided. Earlier defibrotide treatment confirms to be effective. More... »

PAGES

591-599

References to SciGraph publications

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  • 2016-04-25. Busulfan–Melphalan followed by autologous stem cell transplantation in patients with high-risk neuroblastoma or Ewing sarcoma: an exposed–unexposed study evaluating the clinical impact of the order of drug administration in BONE MARROW TRANSPLANTATION
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  • 1995-05. Busulfan disposition and hepatic veno-occlusive disease in children undergoing bone marrow transplantation in CANCER CHEMOTHERAPY AND PHARMACOLOGY
  • 2015-06-01. Tandem high-dose chemotherapy strategy as first-line treatment of primary disseminated multifocal Ewing sarcomas in children, adolescents and young adults in BONE MARROW TRANSPLANTATION
  • 2009-08-15. Radiation Toxicity Following Busulfan/Melphalan High-dose Chemotherapy in the EURO-EWING-99-trial: Review of GPOH Data in STRAHLENTHERAPIE UND ONKOLOGIE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-017-0066-4

    DOI

    http://dx.doi.org/10.1038/s41409-017-0066-4

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29335623


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