Sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation: Incidence, risk factors and outcomes

被引：81

作者：

Yakushijin, K. ^{[1
]}

Atsuta, Y. ^{[2
,3
]}

Doki, N. ^{[4
,5
]}

Yokota, A. ^{[6
]}

Kanamori, H. ^{[7
]}

Miyamoto, T. ^{[8
]}

Ohwada, C. ^{[9
]}

Miyamura, K. ^{[10
]}

Nawa, Y. ^{[11
]}

Kurokawa, M. ^{[12
]}

Mizuno, I. ^{[13
]}

Mori, T. ^{[14
]}

Onizuka, M. ^{[15
]}

Taguchi, J. ^{[16
]}

Ichinohe, T. ^{[17
]}

Yabe, H. ^{[18
]}

Morishima, Y. ^{[19
]}

Kato, K. ^{[20
]}

Suzuki, R. ^{[21
]}

Fukuda, T. ^{[22
]}

机构：

[1] Kobe Univ, Div Med Oncol Hematol, Dept Med, Grad Sch Med, 7-5-2,Kusunoki Cho, Kobe, Hyogo 6500017, Japan

[2] Japanese Data Ctr Hematopoiet Cell Transplantat, Nagoya, Aichi, Japan

[3] Nagoya Univ, Dept Healthcare Adm, Grad Sch Med, Nagoya, Aichi 4648601, Japan

[4] Komagome Hosp, Tokyo Metropolitan Canc, Hematol Div, Tokyo, Japan

[5] Komagome Hosp, Ctr Infect Dis, Tokyo, Japan

[6] Chiba Aoba Municipal Hosp, Dept Hematol, Chiba, Japan

[7] Kanagawa Canc Ctr, Dept Hematol, Kanagawa, Japan

[8] Kyushu Univ, Grad Sch Med Sci, Med & Biosyst Sci, Fukuoka 812, Japan

[9] Chiba Univ Hosp, Dept Hematol, Chiba, Japan

[10] Japanese Red Cross Nagoya First Hosp, Dept Hematol, Nagoya, Aichi, Japan

[11] Ehime Prefectural Cent Hosp, Div Hematol, Matsuyama, Ehime, Japan

[12] Tokyo Univ Hosp, Dept Cell Therapy & Transplantat Med, Tokyo 113, Japan

[13] Hyogo Canc Ctr, Dept Hematol, Kobe, Hyogo, Japan

[14] Keio Univ, Sch Med, Dept Med, Div Hematol, Tokyo 160, Japan

[15] Tokai Univ, Sch Med, Dept Hematol Oncol, Kanagawa 2591100, Japan

[16] Nagasaki Univ Hosp, Atom Bomb Dis & Hibakusha Med Unit, Dept Hematol, Nagasaki, Japan

[17] Hiroshima Univ, Res Inst Radiat Biol & Med, Dept Hematol & Oncol, Hiroshima, Japan

[18] Tokai Univ, Sch Med, Dept Cell Transplantat & Regenerat Med, Kanagawa 2591100, Japan

[19] Aichi Canc Ctr Res, Div Epidemiol & Prevent, Nagoya, Aichi, Japan

[20] Japanese Red Cross Nagoya First Hosp, Childrens Med Ctr, Dept Hematol & Oncol, Nagoya, Aichi, Japan

[21] Nagoya Univ, Grad Sch Med, Dept HSCT Data Management & Biostat, Nagoya, Aichi 4648601, Japan

[22] Natl Canc Ctr, Stem Cell Transplantat Div, 1-1 Tsukiji 5 Chome, Tokyo, Japan

来源：

BONE MARROW TRANSPLANTATION | 2016年 / 51卷 / 03期

关键词：

HEPATIC VENOOCCLUSIVE DISEASE; BONE-MARROW-TRANSPLANTATION; HUMAN SOLUBLE THROMBOMODULIN; NON-RELAPSE MORTALITY; SIGNIFICANT TOXICITY; DEFIBROTIDE; BLOOD; LIVER; INFECTION; FAILURE;

D O I：

10.1038/bmt.2015.283

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

This retrospective study was conducted in Japan to determine the incidence, risk factors and outcomes of sinusoidal obstruction syndrome (SOS) after allogeneic hematopoietic stem cell transplantation (HSCT). Among 4290 patients undergoing allogeneic HSCT between 1999 and 2010, 462 were diagnosed with SOS according to the Seattle criteria (cumulative incidence, 10.8%). The cumulative incidence of SOS diagnosed by the modified Seattle criteria was 9.3%. Of 462 patients, 107 met the Baltimore criteria and 168 had severe SOS with renal and/or respiratory failure. The median onset for SOS was 12 days after HSCT (range, -2-30). Overall survival at day 100 was 32% for SOS and 15% for severe SOS. Multivariate analyses showed that significant independent risk factors for SOS were the number of HSCTs, age, performance status, hepatitis C virus-seropositivity, advanced disease status and myeloablative regimen. SOS was highly associated with overall mortality (hazard ratio, 2.09; P < 0.001). Our retrospective survey showed that the cumulative incidence of SOS in Japan was 10.8%, similar to that previously reported in Western countries, and that the overall survival of patients who developed SOS was low. Furthermore, several risk factors were identified. Preventive and therapeutic strategies for high-risk SOS patients must be established to improve overall survival.

引用

页码：403 / 409

页数：7

共 37 条

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