Veno-occlusive disease of the liver

The success of high-dose cytoreductive strategies depend not only on antitu mor activity but also on the tolerability of treatment. Although advances i n supportive care have significantly reduced mortality due to infection and hemorrhage, regimen-related toxicities remain problematic. Hepatic venoocc lusive disease (VOD) is the most serious regimen-related toxicity after hig h-dose cytoreductive therapy. Risk factors for VOD are well established, bu t the biology of the syndrome remains poorly understood. Unfortunately, no pharmacologic approaches that clearly prevent or treat VOD have been identi fied. A better understanding of the pathogenesis of VOD will lead to more e ffective prevention and treatment strategies. (C) 2000 Lippincott Williams & Wilkins, Inc.