Use of vitamin E and glutamine in the successful treatment of severe veno-occlusive disease following bone marrow transplantation.

Veno-occlusive disease of the liver is a common complication following the administration of conditioning regimens to patients undergoing bone marrow transplantation. Free-radical damage to the liver is believed to be the cause of the hepatic outflow occlusion, and maintenance of adequate antioxidant stores of glutathione and vitamin E may be a means of counteracting the hepatotoxicity. We report the case of a 44-year-old woman who developed severe veno-occlusive disease after bone marrow transplantation and was treated with vitamin E, the major antioxidant of the cell membrane, and glutamine, a precursor of glutathione. The administration of this therapy was associated with reversal of the clinical and biochemical signs of severe hepatic dysfunction.