Effects Of Salvia Miltiorrhiza And Prostaglandin E1 On Hepatic Veno-occlusive Disease After Haemotopoietic Stem Cell Transplantation

Objective: To compare the incidence of hepatic veno-occlusive disease(HVOD) during hematopoietic stem cell transplantation (HSCT ) with prophylactic regimens of salvia miltiorrhiza or prostaglandin El (PGE1) in a retrospective study on 92 consecutive patients received allogeneic stem cell transplantation, and furthermore, to investigate the prophylactic effects of salvia miltiorrhiza and prostaglandin E1 (PGE1) to HVOD by evaluating the variable levels of plasminogen activator inhibitor-1 (PAI-1), protein C(PC), and antithrombin â…¢ (AT-â…¢) during transplantation. Methods: Firstly, 92 consecutive allogeneic stem cell transplantation(Allo-SCT) patients were divided into two groups according to the HVOD prophylactic regimens, those were, the prostaglandin El (PGE1) prophylactic group or the salvia miltiorrhiza prophylactic group. All of the data from case record were analyzed to compare the incidences of HVOD between these two groups. Secondly, 7 patients were allocated two groups into prospective study according to the inpatient number. 3 patients were given PGEl (20ug, iv,ql2h, - 7~-f30d) , and 4 patients were given salvia miltiorrhiza (20ml iv, ql2h, - 7~+30d)as a prophylactic HVOD treatment respectively. The levels of PAI-1, PC, AT-III were measured on day -7d> 0d> +7d> +14d^ +21d> +28d.Results: HVOD was diagnosed as 16.27% (7 of 43 )in the patients of PGEl group, and 4% (2 of 49) in the patients of salvia miltiorrhiza group, and there was a significant difference between these two groups (PO.05) .The levels of PAI-1 were significantly higher in the PGEl group than in the salvia miltiorrhiza group (PO.05 ) , and there were no significant differences between the PGEl group and the salvia miltiorrhiza group in levels of PC and AT-III.Conclusions: Our retrospective study has shown that salvia miltiorrhiza has play a prevent role to HVOD during stem cell transplantation, and the incidence of HVOD in salvia miltiorrhiza prophylactic group was significantly lower than in PGEl prophylactic group. Prospective study suggests that comparing PGEl, salvia miltiorrhiza could inhibit the elevation of PAI-1 more efficiently, and there might be an equal effect to the levels of PC and AT-III.