Incidence and risk factors for hepatic sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation: A retrospective multicenter study of Turkish hematology research and education group (ThREG)


SOYER N., Gunduz M., Tekgunduz E., Deveci B., Ozdogu H., ŞAHİN H. H., ...More

TRANSFUSION AND APHERESIS SCIENCE, vol.59, no.4, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 59 Issue: 4
  • Publication Date: 2020
  • Doi Number: 10.1016/j.transci.2020.102827
  • Journal Name: TRANSFUSION AND APHERESIS SCIENCE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, Biotechnology Research Abstracts, EMBASE, MEDLINE
  • Keywords: Sinusoidal obstruction syndrome, Prophylaxis, Defibrotide, Hematopoietic stem cell transplantation, VENOOCCLUSIVE DISEASE, MARROW-TRANSPLANTATION, DEFIBROTIDE, LIVER, PROPHYLAXIS, DIAGNOSIS, BLOOD
  • Erciyes University Affiliated: Yes

Abstract

Hepatic sinusoidal obstruction syndrome (HSOS) is a potentially life-threatening complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively evaluated the incidence, risk factors, treatment and survival for HSOS after allo-HSCT in Turkey. We also reported our experience of defibrotide (DF) for HSOS prophylaxis in high-risk (HR) patients. Across Turkey, 1153 patients from 10 centers were enrolled in the study. We evaluated the medical records of patients who were treated with allo-SCT between January 2012 and December 2015. The study included 1153 patients (687 males/466 females) with median age of 38 (15 - 71) years. The incidence of HSOS was 7.5 % (n = 86). The incidences of HSOS in the HR/DF +, HR/DF- and standard risk (SR) group were 8%, 66.7 % and 6.2 %, respectively. The rate of HSOS development was not statistically different between HR/DF + and SR group (p = 0.237). HSOS prophylaxis (defibrotide) was significantly decreased HSOS-related mortality (p = 0.004). The incidence of HSOS was found similar to literature in this large Turkish cohort. Defibrotide prophylaxis appears to be associated with low incidence of HSOS development and reduced HSOS-related mortality. Although these results are promising, future studies are needed to support the efficacy of defibrotide prophylaxis in patients with risk of HSOS.