Underdiagnosed veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) as a major cause of multi-organ failure in acute leukemia transplant patients: an analysis ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-11-18

AUTHORS

Abdul Hamid Bazarbachi, Rama Al Hamed, Myriam Labopin, Kazimierz Halaburda, Helene Labussiere, Paolo Bernasconi, Wilfried Schroyens, Virginie Gandemer, Nicolaas P. M. Schaap, Michael Loschi, Pavel Jindra, John Snowden, Depei Wu, Blandine Guffroy, Montserrat Rovira, Sylvain P. Chantepie, Xavier Poiré, Lucia Lopez-Corral, Manos Nikolousis, Matteo Pelosini, Fabio Ciceri, Frederic Baron, Ali Bazarbachi, Selim Corbacioglu, Bipin N. Savani, Zinaida Peric, Arnon Nagler, Enric Carreras, Mohamad Mohty

ABSTRACT

Allogeneic hematopoietic cell transplantation (alloHCT) is a complex, potentially fatal therapy featuring a myriad of complications. Triggering event(s) of such complications vary significantly, but often a so-called “multi-organ failure” (MOF) is reported as the leading cause of death. The identification of the exact trigger of MOF is critical towards early and disease-specific intervention to improve outcome. We examined data from 202 alloHCT patients reported to have died of MOF from the EBMT registry aiming to determine their exact cause of death focusing on veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) due to its life-threatening, often difficult to capture yet preventable nature. We identified a total of 70 patients (35%) for whom VOD/SOS could be considered as trigger for MOF and leading cause of death, among which 48 (69%) were previously undiagnosed. Multivariate analysis highlighted history of hepatic comorbidity or gentuzumab use and disease status beyond CR1 as the only significant factors predictive of VOD/SOS incidence (OR = 6.6; p = 0.001 and OR = 3.3; p = 0.004 respectively). VOD/SOS-related MOF was widely under-reported, accounting for 27% of deaths attributed to MOF of unknown origin without a previous VOD/SOS diagnosis. Our results suggest most missed cases developed late VOD/SOS beyond 21 days post-alloHCT, highlighting the importance of the newly revised EBMT criteria. More... »

PAGES

917-927

References to SciGraph publications

Journal

TITLE

Bone Marrow Transplantation

ISSUE

4

VOLUME

56

Author Affiliations

  • Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
  • Division of Infectious Diseases, Brigham & Women’s, Harvard Medical School, Boston, MA, USA
  • Sorbonne University, Department of Clinical Hematology and Cellular Therapy, Saint Antoine Hospital, INSERM UMR 938, Paris, France
  • Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
  • Département d’Hématologie, Hospices Civils de Lyon, Pierre-Bénite, France
  • HSCT Unit, SC Ematologia, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
  • University Hospital Antwerp, Edegem, Belgium
  • Department of Pediatric Oncology and Haematology, University Hospital of Rennes, Rennes, France
  • Radboud University Medical Centre, Nijmegen, The Netherlands
  • Service d’hématologie, Centre Hospitalier Universitaire, 06000, Nice, France
  • Department of Haematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic
  • Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  • Department of Hematology, The Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, 215006, Suzhou, China
  • Department of Hematology, Hopitaux Universitaires Strasbourg, Strasbourg, France
  • BMT Unit, Department of Hematology, IDIBAPS, Hospital Clinic, Institut Josep Carreras, Barcelona, Spain
  • Caen University Hospital, Hematology Institute, Caen, France
  • Department of Hematology, Saint-Luc University Hospital, Brussels, Belgium
  • Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL; Centro de Investigación del Cáncer-IBMCC, Salamanca, Spain
  • Heartlands Hospital, Birmingham, UK
  • Hematology Division, University of Pisa, Pisa, Italy
  • Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
  • Department of Hematology, University and CHU of Liège, 4000, Liège, Belgium
  • Department of Internal Medicine, American University of Beirut, 1107 2020, Beirut, Lebanon
  • Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Franz-Josef-Strauss-Allee 11, University Hospital of Regensburg, Regensburg, Germany
  • Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
  • Department of Hematology, School of Medicine, University of Zagreb, Zagreb, Croatia
  • Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-HaShomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
  • Josep Carreras Foundation and Research Institute, Hospital Clinic/University of Barcelona Campus, Barcelona, Spain
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-020-01135-3

    DOI

    http://dx.doi.org/10.1038/s41409-020-01135-3

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1132679686

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33208915


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