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Prevention of Hepatic Veno-Occlusive Disease with Pentoxifylline after Allogeneic Hematopoietic Stem Cell Transplantation
J. Kor. Soc. Health-syst. Pharm. 2019;36:335-343
Published online August 31, 2019;  https://doi.org/10.32429/jkshp.2019.36.3.003
© 2019 Korean Society of Health-System Pharmacists

Nam Hee Kim, So Young Lee, Jae Song Kim and Eun Sun Son

Department of Pharmacy, Severance Hospital, Yon-sei University Health System, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
Correspondence to: 손은선 Tel:02-2228-6888 E-mail:sespharm@yuhs.ac
Received February 13, 2019; Revised March 27, 2019; Accepted June 26, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background : Veno-occlusive disease (VOD) is a potentially devastating complication that can develop after hematopoietic stem cell transplantation (HSCT). The incidence is higher for allogeneic than autologous HSCT. Previous studies on the prevention of VOD with pentoxifylline have limitations to apply for the present state due to the difference of VOD criteria.
This study examines the effectiveness of pentoxifylline in preventing VOD according to current diagnostic criteria for a patient with allogeneic HSCT.
Methods : Allogeneic HSCT recipients from 2013 to 2018 were selected for this retrospective analysis. Subjects were divided into three groups depending on pentoxifylline administration.
The first and the second group took pentoxifylline for more than two weeks and for less than two weeks respectively, while the last group did not take it. The primary endpoints were the incidence rates of VOD. Secondary endpoints were hyperbilirubinemia (≥2 mg/dL), weight gain (>5% of baseline), painful hepatomegaly, ascites, and taking VOD treatment (defibrotide) or liver function agent.
Results : 210 patients were included. The incidence rate of VOD was 5.0% in the first group vs. 6.5% in the second group vs. 6.5% in the last group (p=0.779). There was no significantly difference in hyperbilirubinemia (p=0.844), weight gain (p=0.292), painful hepatomegaly (p=0.093), ascites (p=0.912), taking defibrotide (p=0.886), taking liver function agent (p=0.508).
Conclusions : This study confirmed that there is no VOD prevention effect of pentoxifylline in patients with allogeneic HSCT. Further studies are needed to develop more effectiveness prophylactic approaches of VOD.
Keywords : Pentoxifylline, Prophylaxis, VOD (Veno-Occlusive Disease), Allogeneic hematopoietic stem cell transplantation


August 2019, 36 (3)