Danaparoid as the prophylaxis for hepatic veno-occlusive disease after allogeneic hematopoietic stem cell transplantation in childhood hematological malignancy

Hirotoshi Sakaguchi, Nobuhiro Watanabe, Hideki Muramatsu, Sayoko Doisaki, Nao Yoshida, Kimikazu Matsumoto, Koji Kato

    Research output: Contribution to journalArticle

    11 Citations (Scopus)

    Abstract

    Background: Veno-occlusive disease (VOD) is a regimen-related toxicity that occurs in the early phase of hematopoietic stem cell transplantation (HSCT). Therapeutic modalities for established VOD are limited, and severe VOD characterized by multiple organ failure is associated with a fatal prognosis despite intensive supportive care. Procedure: We analyzed the data of 95 consecutive allogeneic HSCT for childhood hematological malignancies, and assessed the efficacy of our VOD prophylaxis regimen based on danaparoid (n = 48), comparing with historical control regimen based on dalteparin (n = 47). Results: Eight patients (danaparoid cohort in one; dalteparin cohort in seven) developed VOD on day +30 (median onset, day +22; range, day +11 to day +28) after HSCT. The probability of developing VOD for the danaparoid cohort was 2% (95% CI, 0-6%) and that of the dalteparin cohort was 15% (95% CI, 5-26%). In the Cox hazard proportional model, the danaparoid cohort had a significant advantage over the dalteparin cohort for the prophylaxis of VOD (hazard ratio (HR), 0.0; 95% CI, 0.0-0.3; P < 0.01) without increasing hemorrhagic events. Conclusions: Our findings suggest that danaparoid may have promise for the prophylaxis of VOD after allogeneic HSCT and further randomized studies are warranted.

    Original languageEnglish
    Pages (from-to)1118-1125
    Number of pages8
    JournalPediatric Blood and Cancer
    Volume55
    Issue number6
    DOIs
    Publication statusPublished - Dec 1 2010

    Fingerprint

    Hepatic Veno-Occlusive Disease
    Hematopoietic Stem Cell Transplantation
    Hematologic Neoplasms
    Dalteparin
    Multiple Organ Failure
    danaproid
    Critical Care
    Proportional Hazards Models

    All Science Journal Classification (ASJC) codes

    • Pediatrics, Perinatology, and Child Health
    • Hematology
    • Oncology

    Cite this

    Danaparoid as the prophylaxis for hepatic veno-occlusive disease after allogeneic hematopoietic stem cell transplantation in childhood hematological malignancy. / Sakaguchi, Hirotoshi; Watanabe, Nobuhiro; Muramatsu, Hideki; Doisaki, Sayoko; Yoshida, Nao; Matsumoto, Kimikazu; Kato, Koji.

    In: Pediatric Blood and Cancer, Vol. 55, No. 6, 01.12.2010, p. 1118-1125.

    Research output: Contribution to journalArticle

    Sakaguchi, Hirotoshi ; Watanabe, Nobuhiro ; Muramatsu, Hideki ; Doisaki, Sayoko ; Yoshida, Nao ; Matsumoto, Kimikazu ; Kato, Koji. / Danaparoid as the prophylaxis for hepatic veno-occlusive disease after allogeneic hematopoietic stem cell transplantation in childhood hematological malignancy. In: Pediatric Blood and Cancer. 2010 ; Vol. 55, No. 6. pp. 1118-1125.
    @article{a6e9df43798f45a39651bab4f6e3ebf3,
    title = "Danaparoid as the prophylaxis for hepatic veno-occlusive disease after allogeneic hematopoietic stem cell transplantation in childhood hematological malignancy",
    abstract = "Background: Veno-occlusive disease (VOD) is a regimen-related toxicity that occurs in the early phase of hematopoietic stem cell transplantation (HSCT). Therapeutic modalities for established VOD are limited, and severe VOD characterized by multiple organ failure is associated with a fatal prognosis despite intensive supportive care. Procedure: We analyzed the data of 95 consecutive allogeneic HSCT for childhood hematological malignancies, and assessed the efficacy of our VOD prophylaxis regimen based on danaparoid (n = 48), comparing with historical control regimen based on dalteparin (n = 47). Results: Eight patients (danaparoid cohort in one; dalteparin cohort in seven) developed VOD on day +30 (median onset, day +22; range, day +11 to day +28) after HSCT. The probability of developing VOD for the danaparoid cohort was 2{\%} (95{\%} CI, 0-6{\%}) and that of the dalteparin cohort was 15{\%} (95{\%} CI, 5-26{\%}). In the Cox hazard proportional model, the danaparoid cohort had a significant advantage over the dalteparin cohort for the prophylaxis of VOD (hazard ratio (HR), 0.0; 95{\%} CI, 0.0-0.3; P < 0.01) without increasing hemorrhagic events. Conclusions: Our findings suggest that danaparoid may have promise for the prophylaxis of VOD after allogeneic HSCT and further randomized studies are warranted.",
    author = "Hirotoshi Sakaguchi and Nobuhiro Watanabe and Hideki Muramatsu and Sayoko Doisaki and Nao Yoshida and Kimikazu Matsumoto and Koji Kato",
    year = "2010",
    month = "12",
    day = "1",
    doi = "10.1002/pbc.22645",
    language = "English",
    volume = "55",
    pages = "1118--1125",
    journal = "Pediatric Blood and Cancer",
    issn = "1545-5009",
    publisher = "Wiley-Liss Inc.",
    number = "6",

    }

    TY - JOUR

    T1 - Danaparoid as the prophylaxis for hepatic veno-occlusive disease after allogeneic hematopoietic stem cell transplantation in childhood hematological malignancy

    AU - Sakaguchi, Hirotoshi

    AU - Watanabe, Nobuhiro

    AU - Muramatsu, Hideki

    AU - Doisaki, Sayoko

    AU - Yoshida, Nao

    AU - Matsumoto, Kimikazu

    AU - Kato, Koji

    PY - 2010/12/1

    Y1 - 2010/12/1

    N2 - Background: Veno-occlusive disease (VOD) is a regimen-related toxicity that occurs in the early phase of hematopoietic stem cell transplantation (HSCT). Therapeutic modalities for established VOD are limited, and severe VOD characterized by multiple organ failure is associated with a fatal prognosis despite intensive supportive care. Procedure: We analyzed the data of 95 consecutive allogeneic HSCT for childhood hematological malignancies, and assessed the efficacy of our VOD prophylaxis regimen based on danaparoid (n = 48), comparing with historical control regimen based on dalteparin (n = 47). Results: Eight patients (danaparoid cohort in one; dalteparin cohort in seven) developed VOD on day +30 (median onset, day +22; range, day +11 to day +28) after HSCT. The probability of developing VOD for the danaparoid cohort was 2% (95% CI, 0-6%) and that of the dalteparin cohort was 15% (95% CI, 5-26%). In the Cox hazard proportional model, the danaparoid cohort had a significant advantage over the dalteparin cohort for the prophylaxis of VOD (hazard ratio (HR), 0.0; 95% CI, 0.0-0.3; P < 0.01) without increasing hemorrhagic events. Conclusions: Our findings suggest that danaparoid may have promise for the prophylaxis of VOD after allogeneic HSCT and further randomized studies are warranted.

    AB - Background: Veno-occlusive disease (VOD) is a regimen-related toxicity that occurs in the early phase of hematopoietic stem cell transplantation (HSCT). Therapeutic modalities for established VOD are limited, and severe VOD characterized by multiple organ failure is associated with a fatal prognosis despite intensive supportive care. Procedure: We analyzed the data of 95 consecutive allogeneic HSCT for childhood hematological malignancies, and assessed the efficacy of our VOD prophylaxis regimen based on danaparoid (n = 48), comparing with historical control regimen based on dalteparin (n = 47). Results: Eight patients (danaparoid cohort in one; dalteparin cohort in seven) developed VOD on day +30 (median onset, day +22; range, day +11 to day +28) after HSCT. The probability of developing VOD for the danaparoid cohort was 2% (95% CI, 0-6%) and that of the dalteparin cohort was 15% (95% CI, 5-26%). In the Cox hazard proportional model, the danaparoid cohort had a significant advantage over the dalteparin cohort for the prophylaxis of VOD (hazard ratio (HR), 0.0; 95% CI, 0.0-0.3; P < 0.01) without increasing hemorrhagic events. Conclusions: Our findings suggest that danaparoid may have promise for the prophylaxis of VOD after allogeneic HSCT and further randomized studies are warranted.

    UR - http://www.scopus.com/inward/record.url?scp=77958521968&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=77958521968&partnerID=8YFLogxK

    U2 - 10.1002/pbc.22645

    DO - 10.1002/pbc.22645

    M3 - Article

    C2 - 20589662

    AN - SCOPUS:77958521968

    VL - 55

    SP - 1118

    EP - 1125

    JO - Pediatric Blood and Cancer

    JF - Pediatric Blood and Cancer

    SN - 1545-5009

    IS - 6

    ER -