Veno-Occlusive Disease of the Liver After Allogeneic Bone Marrow Transplantation

Abstract

Acute veno-occlusive disease of the liver developed in 7 of 29 patients undergoing bone marrow transplantation for treatment of leukemia, aplastic anemia or disseminated carcinomatosis. All 7 died despite successful marrow engraftment. Hepatic failure was the principal cause of death in 4 and contributory in 3. The veno-occlusive disease did not relate to the nature of the pretransplant immunosuppressive regimen, since it occurred in patients receiving irradiation alone, chemotherapy alone or both. Of the patients, 22 were autopsied. Among these, the lesion was found in 7 of 11 in whom a graft vs. host reaction developed but in none of the 11 without such a reaction who received similar pretransplant immunosuppression (P < 0.025). Acute veno-occlusive disease of the liver appears to be a complication of allogeneic bone marrow transplantation related to the development of a graft vs. host reaction.