Preservation of Ovarian Function after Hematopoietic Cell Transplantation (HCT): More Possible Than We Thought?

Abstract

s / Biol Blood Marrow Transplant 21 (2015) S171eS184 S178 and level of supportive care given was significantly higher in patients with icterus than without (P 1⁄4 0.224) and P1⁄4 0.0081) respectively. Total days for disease resolution in patients with icterus was 32 days compared to 16 days for those without (p1⁄40.022). Nine of the patients with icterus received specific treatment compared to only one in the anicteric group. Seven cases were diagnosed with VOD by the Seattle criteria at a median of day +15 post HSCT, but treatment was delayed by 1-11 days for lack of hyperbilirubinemia, 2 of these never developed hyperbilirubinemia; 4 of 7 cases died. Overall 2 with anicteric and 12 cases with icteric VOD died. Discussion: The Baltimore criteria appear to bemore stringent and cases with anicteric VOD do not meet these diagnostic criteria. This retrospective study describes the features of anicteric VOD at a single center. Even if the patients met the Seattle criteria, treatment was delayed for lack of hyperbilirubinemia or flow reversal on hepatic ultrasound, neither of which are required criteria. Patients with anicteric VOD had a better outcome than those with hyperbilirubinemia, but our study shows that there can be significant morbidity and even mortality associated with anicteric VOD. There seems to be a poor understanding and awareness of anicteric VOD as a diagnosis.Earlierdisease recognitioncould lead tomorepromptand aggressive treatment leading to improved outcomes.