Hepatic sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation in adult patients with idiopathic aplastic anemia

Hawk Kim, Kyoo Hyung Lee, Sang Kyun Sohn, Chul Won Jung, Young Don Joo, Sung Hyun Kim, Byung Soo Kim, Jung Hye Choi, Jae Yong Kwak, Min Kyoung Kim, Sung Hwa Bae, Ho Jin Shin, Jong Ho Won, Sukjoong Oh, Won Sik Lee, Jae Hoo Park, Sung Soo Yoon

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 (200mg/m2)-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 200mg/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.

Original languageEnglish
Pages (from-to)1241-1247
Number of pages7
JournalLeukemia Research
Volume37
Issue number10
DOIs
Publication statusPublished - 2013 Oct 1

Fingerprint

Hepatic Veno-Occlusive Disease
Hematopoietic Stem Cell Transplantation
Liver
Horses
Aplastic Anemia
Weight Gain
Survival Rate
Rabbits
Survival
Mortality
Idiopathic Aplastic anemia
Incidence

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Aplastic anemia
  • Sinusoidal obstruction syndrome
  • Veno-occlusive disease

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Hepatic sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation in adult patients with idiopathic aplastic anemia. / 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.

In: Leukemia Research, Vol. 37, No. 10, 01.10.2013, p. 1241-1247.

Research output: Contribution to journalArticle

Kim, H, Lee, KH, Sohn, SK, Jung, CW, Joo, YD, Kim, SH, Kim, BS, Choi, JH, Kwak, JY, Kim, MK, Bae, SH, Shin, HJ, Won, JH, Oh, S, Lee, WS, Park, JH & Yoon, SS 2013, 'Hepatic sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation in adult patients with idiopathic aplastic anemia', Leukemia Research, vol. 37, no. 10, pp. 1241-1247. https://doi.org/10.1016/j.leukres.2013.06.024
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. / Hepatic sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation in adult patients with idiopathic aplastic anemia. In: Leukemia Research. 2013 ; Vol. 37, No. 10. pp. 1241-1247.
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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 (200mg/m2)-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 200mg/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.",
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AU - Jung, Chul Won

AU - Joo, Young Don

AU - Kim, Sung Hyun

AU - Kim, Byung Soo

AU - Choi, Jung Hye

AU - Kwak, Jae Yong

AU - Kim, Min Kyoung

AU - Bae, Sung Hwa

AU - Shin, Ho Jin

AU - Won, Jong Ho

AU - Oh, Sukjoong

AU - Lee, Won Sik

AU - Park, Jae Hoo

AU - Yoon, Sung Soo

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N2 - 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 (200mg/m2)-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 200mg/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.

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