{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:21:16Z","timestamp":1792254076570,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2009,11,12]],"date-time":"2009-11-12T00:00:00Z","timestamp":1257984000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatic veno\u2010occlusive disease (VOD) is one of the most serious complications in stem cell transplantation (SCT). Although plasma protein C activity decreases in VOD after SCT, the timeframe of plasma protein C activity decreases during SCT is not known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We examined levels of plasma protein C serially during the course of SCT to determine the critical level and risk factors for VOD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 151 children who received SCT, 12 of them (7.9%) developed VOD. The mean minimum protein C activity in patients with VOD was significantly lower compared to that in patients without VOD (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Receiver operating characteristic curve analysis revealed that the critical plasma protein C activity (cut\u2010off point) for VOD was identified to be 34.5% with high sensitivity (100%) and specificity (83.3%), and the reduction of plasma protein C below the cut\u2010off level (day +6.50\u2009\u00b1\u20092.43) was observed mostly prior to the onset of VOD (day +7.33\u2009\u00b1\u20092.64). The patients receiving melphalan in conditioning were found to be at high risk for VOD (<jats:italic>P<\/jats:italic>\u2009=\u20090.003). Among the melphalan containing regimens, melphalan\u2009+\u2009carboplatin\u2009+\u2009etoposide was a significant risk factor for depression of plasma protein C (<jats:italic>P<\/jats:italic>\u2009=\u20090.037).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Plasma protein C level was a useful parameter of VOD after SCT, and activity below 34.5% was critical for VOD. The use of melphalan in conditioning causes a high risk for VOD. Pediatr Blood Cancer 2010;54:437\u2013443. \u00a9 2009 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.22314","type":"journal-article","created":{"date-parts":[[2009,11,12]],"date-time":"2009-11-12T16:24:42Z","timestamp":1258043082000},"page":"437-443","source":"Crossref","is-referenced-by-count":19,"title":["Plasma protein C is a useful clinical marker for hepatic veno\u2010occlusive disease (VOD) in stem cell transplantation"],"prefix":"10.1002","volume":"54","author":[{"given":"Akihiro","family":"Iguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoji","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Kaneda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiko","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,11,12]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840040121"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-4-199302150-00003"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705899"},{"key":"e_1_2_6_5_2","first-page":"39","article-title":"Changes in natural anticoaglants following bone marrow transplantation","volume":"5","author":"Harper PL","year":"1990","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0049-3848(91)90176-W"},{"key":"e_1_2_6_7_2","doi-asserted-by":"crossref","first-page":"3458","DOI":"10.1182\/blood.V81.12.3458.3458","article-title":"Naturally occurring anticoagulants and bone marrow transplantation: Plasma protein C predicts the development of venocculusive disease of the liver","volume":"81","author":"Faioni EM","year":"1993","journal-title":"Blood"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199302000-00036"},{"key":"e_1_2_6_9_2","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1182\/blood.V83.8.2385.2385","article-title":"High plasma levels of tumor necrosis factor\u2010\u03b1 may be predictive of veno\u2010occulusive disease in bone marrow transplantation","volume":"83","author":"Gugliotta L","year":"1994","journal-title":"Blood"},{"key":"e_1_2_6_10_2","first-page":"173","article-title":"Changes in plasma transforming growth factor beta in response to high\u2010dose chemotherapy for stage II breast cancer: Possible implications for the prevention of hepatic veno\u2010occulusive disease and pulmonary drug toxicity","volume":"15","author":"Murase T","year":"1995","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703061"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1701506"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703281"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704085"},{"key":"e_1_2_6_15_2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1182\/blood.V68.1.119.119","article-title":"Marrow transplantation for severe aplastic anemia: Methotrexate and cyclosporine for prevention of acute graft\u2010versus\u2010host disease","volume":"68","author":"Stob R","year":"1986","journal-title":"Blood"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-197410000-00001"},{"key":"e_1_2_6_17_2","first-page":"1396","article-title":"A prospective survey on incidence, risk factors and therapy of hepatic veno\u2010occlusive disease in children after hematopoietic stem cell transplantation","volume":"90","author":"Cesaro S","year":"2005","journal-title":"Haematologica"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705835"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704069"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.103.049379"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.13.6028"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07342.x"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1701445"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702624"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705114"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2006.00612.x"}],"container-title":["Pediatric Blood &amp; 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