Skill Checkup: A Man Who Had Autologous Hematopoietic Stem Cell Transplantation Developed Acute Graft-vs-Host Disease

James L. Harper, MD


February 10, 2022

Agents that have been evaluated for veno-occlusive disease prophylaxis include antithrombin, prostaglandin E1, and pentoxifylline. However, none of these agents have shown efficacy for veno-occlusive disease prevention, and some may be associated with severe side effects. Therefore, they are not recommended.

Ursodeoxycholic acid for veno-occlusive disease prevention has been evaluated in several prospective randomized trials. Continuous administration until 90 days after transplantation has been shown to significantly reduce the proportion of patients developing high serum bilirubin levels, severe acute graft-vs-host disease, liver graft-vs-host disease, and intestinal graft-vs-host disease, translating into a significantly lower nonrelapse mortality and better overall survival. Therefore, the use of ursodeoxycholic acid is recommended from the beginning of conditioning until day 90 after transplantation.


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