Veno-Occlusive Disease: An Interview with Phyllis McKiernan, APN, MSN, OCN® and Michelle N. Rickard, DNP, CPNP-AC, CHPPN, BMTCN, CPON

Veno-occlusive disease (VOD) is a potentially life-threatening complication of hematopoietic stem cell transplant. In patients with severe cases, the mortality rate has been estimated to be greater than 80%. In this exclusive interview, Phyllis McKiernan, APN, MSN, OCN and Michelle Rickard, DNP, CPNP-AC, CHPPN, BMTCN, CPON spoke with i3 Health about challenges, patient education strategies, and best practices in nursing management of adult and pediatric patients with VOD.​

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What do you consider "sorafenib failure?" Progression on radiological evaluation, clinical evaluation, or both?

Thomas A. Abrams, MD: Clinical deterioration that is not related to obvious AEs of sorafenib has to be regarded as a progression or sorafenib failure, especially if there's corroborating evidence such as biochemical worsening, AFPs going up, worsening liver function, or ascites. Those could be used as a surrogate to progression. If radiological data suggest that the disease is getting worse with new or enlarged lesions, worsening portal venous thrombus, or worsening liver function due to increas...
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