Successful therapy of transplant-associated veno-occlusive disease with a combination of tissue plasminogen activator and defibrotide

M. J. Jenner, I. N.M. Micallef, A. Z. Rohatiner, S. M. Kelsey, A. C. Newland, J. D. Cavenagh

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

A 36-year-old man underwent matched unrelated donor bone marrow transplantation for chronic myeloid leukaemia. He developed severe hepatic veno-occlusive disease as an early post-transplant complication. Tissue plasminogen activator was initially felt to be contraindicated since the patient had concomitant pericarditis. Defibrotide was therefore commenced as treatment for veno-occlusive disease. The pericarditis improved but the veno-occlusive disease continued to worsen (peak bilirubin 353 μmol/l). Tissue plasminogen activator followed by a heparin infusion was therefore administered. However, he proceeded to develop haemorrhagic cardiac tamponade that required drainage. Thrombolysis was therefore discontinued and treatment with defibrotide resumed after an interval of 48 h. The veno-occlusive disease gradually resolved and defibrotide was discontinued once the bilirubin had plateaued. He was discharged home on day +52 post-transplant.

Original languageEnglish (US)
Pages (from-to)333-336
Number of pages4
JournalMedical Oncology
Volume17
Issue number4
DOIs
StatePublished - Jan 1 2000

Keywords

  • Bone marrow transplantation
  • Defibrotide
  • Tissue plasminogen activator
  • Veno-occlusive disease

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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