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Case Reports
. 2024 Jul 1;46(5):e348-e353.
doi: 10.1097/MPH.0000000000002886. Epub 2024 May 30.

Veno-Occlusive Disease: A Life-saving Novel Approach With Plasma Exchange, IVIG, and Steroid, Without Defibrotide

Banu Katlan  1 , Funda Erkasar  2 , Mesut Topdemir  3 , Gulçin Günaydin  4 , Alptug Ozen  4
Affiliations
Case Reports

Veno-Occlusive Disease: A Life-saving Novel Approach With Plasma Exchange, IVIG, and Steroid, Without Defibrotide

Banu Katlan et al. J Pediatr Hematol Oncol. .

Abstract

Introduction: Hepatic veno-occlusive disease (VOD) is a critical medical emergency with a high mortality rate of up to 90% if not promptly treated. Defibrotide is the only approved medication for VOD treatment, exhibiting anti-inflammatory, antithrombotic, and anti-ischemic properties. This report presents a case of severe VOD in a patient undergoing acute lymphoblastic leukemia (ALL) treatment.

Case presentation: We describe the successful and rapid treatment of severe VOD in an ALL patient using therapeutic plasma exchange (TPE), intravenous immunoglobulin (IVIG), and methylprednisolone (MPZ). The patient showed significant clinical and laboratory improvement after this combined therapeutic approach.

Conclusion: This case highlights the effectiveness of TPE, IVIG, and MPZ in the treatment of severe VOD in ALL patients, providing insights into alternative therapeutic strategies in the absence of Defibrotide.

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Conflict of interest statement

The authors declare no conflict of interest.

References

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