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Prophylactic Danshen Injection Combined with Prostaglandin E1 and Low-dose Heparin may prevent Hepatic Veno-occlusive Disease after Hematopoietic Stem Cell Transplantation: A Single-center Study in China

Xiaoning Wang, Chunhong Sun, Caili Guo, Pengcheng He, Mei Zhang

Objective: To investigate the effect of Danshen injection combined with prostaglandin E1 and low-dose heparinon prevention of hepatic veno-occlusive disease (HVOD) after hematopoietic stem cell transplantation (HSCT). Methods: A total of 126 patients undergoing HSCT between January 2008 and June 2015, received a combined prophylactic regimen of intravenous Danshen 20-30 ml/day, prostaglandin E 120-30 μg/d, and subcutaneous injection of low-dose heparin (100 U/kg/day) for prevention of HVOD. The incidence of HVOD and adverse events associated with this prophylactic regimen were observed.

Results: Among 126 patients, 65 received autologous peripheral blood stem cell transplant, 34 received HLAidentical sibling HSCT, six received HLA mismatched siblingHSCT, seven received HLA-matched unrelated HSCT, and 14 received HLA-mismatched unrelated HSCT. No adverse reaction or coagulation disorder associated with this prophylactic regimen was observed. Only one case with acute myeloid leukemia (CR2) developed HVOD seven days after receiving myeloablative chemotherapy with oral busulfan and cyclophosphamide followed by HLAmismatched unrelated peripheral blood stem cell transplantation. This patient died of HVOD.

Conclusion: Danshen injection combined with prostaglandin E1 and low-dose heparin is a safe and effective regimen for the prevention of HVOD after HSCT.