Hepatic sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation in adult patients with idiopathic aplastic anemia
- Authors
- Kim, Hawk; Lee, Kyoo-Hyung; Sohn, Sang Kyun; Jung, Chul Won; Joo, Young Don; Kim, Sung Hyun; Kim, Byung Soo; Choi, Jung Hye; Kwak, Jae-Yong; Kim, Min Kyoung; Bae, Sung Hwa; Shin, Ho-Jin; Won, Jong Ho; Oh, Sukjoong; Lee, Won Sik; Park, Jae-Hoo; Yoon, Sung-Soo
- Issue Date
- 10월-2013
- Publisher
- PERGAMON-ELSEVIER SCIENCE LTD
- Keywords
- Sinusoidal obstruction syndrome; Veno-occlusive disease; Aplastic anemia; Allogeneic hematopoietic stem cell transplantation
- Citation
- LEUKEMIA RESEARCH, v.37, no.10, pp.1241 - 1247
- Indexed
- SCIE
SCOPUS
- Journal Title
- LEUKEMIA RESEARCH
- Volume
- 37
- Number
- 10
- Start Page
- 1241
- End Page
- 1247
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/102037
- DOI
- 10.1016/j.leukres.2013.06.024
- ISSN
- 0145-2126
- Abstract
- We retrospectively investigated the incidence, risk factors, and outcomes of SOS (sinusoidal obstruction syndrome; previously veno-occlusive disease [VOD]) after allogeneic hematopoietic stem cell transplantation (alloHSCT) in aplastic anemia. Two hundred and sixty patients were included in the analysis. SOS developed in 7.3% (n = 19/260) of patients. Classical Cy (200 mg/m(2))-ATG was the most common conditioning regimen (84.2%) in the SOS group. The SOS mortality rate was 4/19 (21.1%). Univariate analyses revealed that Cy 200 mg/m2 conditioning (p = 0.035), classical Cy-ATG conditioning (p = 0.007), and horse ATG conditioning (p < 0.001) were significant risk factors for developing SOS. Multivariate analysis revealed that only horse ATG conditioning was a poor prognostic factor (HR = 3.484; 95% CI 1.226-9.904; p = 0.002). Rabbit ATG (HR 12.719; 95% CI 2.332-69.373; p = 0.003) and weight gain > 10% (HR 35.655; 95% CI 2.208-575.805; p = 0.012) were risk factors in the overall SOS group. Both rabbit ATG conditioning and weight gain of more than 10% were associated with poor overall survival with a median of 1.2 months (5Y survival rate, any risk factor vs. none: 74.6% vs. 0.0%; p < 0.001; Fig. 2) in the SOS group. In conclusion, SOS is a relatively rare (7.3%) but highly fatal (21.1%) acute complication of alloHSCT in AA, and the horse ATG conditioning regimen was a significant risk factor for developing SOS. (C) 2013 Elsevier Ltd. All rights reserved.
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