title: High pre-transplant serum ferritin and busulfan-thiotepa conditioning regimen as risk factors for hepatic sinusoidal obstructive syndrome after autologous stem cell transplantation in patients with malignant lymphoma.
abstract: Few studies have evaluated the risk factors for hepatic sinusoidal obstructive syndrome (SOS) in patients with malignant lymphoma receiving autologous stem cell transplantation (ASCT). We retrospectively analyzed 132 malignant lymphoma patients who underwent ASCT. Intravenous busulfan-based conditioning regimens were used in 108 (81.8%) patients. The combination of heparin and ursodeoxycholic acid was used for prophylaxis of SOS. Hepatic SOS was developed in 10 (7.6%) patients at a median of 30 days post-ASCT. In nine (90.0%) patients, SOS was diagnosed after 20 days post-ASCT. Two patients developed severe SOS and eventually died from multiple organ failure. In multivariate analysis, the use of the busulfan-thiotepa conditioning regimen (p = 0.003) and a high pre-transplant serum ferritin level (≥ 950 ng/mL) (p = 0.003) were risk factors for hepatic SOS. The evaluation of pre-transplant serum ferritin may be helpful in determining the most appropriate conditioning regimen with a lower risk of SOS.
authors.affiliation: a Division of Hematology, Department of Internal Medicine , Seoul , Korea.
authors.forename: Doh Yu
authors.initials: DY
authors.lastname: Hwang
authors.affiliation: a Division of Hematology, Department of Internal Medicine , Seoul , Korea.
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: a Division of Hematology, Department of Internal Medicine , Seoul , Korea.
authors.forename: June-Won
authors.initials: JW
authors.lastname: Cheong
authors.affiliation: a Division of Hematology, Department of Internal Medicine , Seoul , Korea.
authors.forename: Yundeok
authors.initials: Y
authors.lastname: Kim
authors.affiliation: a Division of Hematology, Department of Internal Medicine , Seoul , Korea.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Jang
authors.affiliation: a Division of Hematology, Department of Internal Medicine , Seoul , Korea.
authors.forename: Jung Yeon
authors.initials: JY
authors.lastname: Lee
authors.affiliation: a Division of Hematology, Department of Internal Medicine , Seoul , Korea.
authors.forename: Yoo Hong
authors.initials: YH
authors.lastname: Min
authors.affiliation: b Department of Pathology , Severance Hospital, Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Woo Ick
authors.initials: WI
authors.lastname: Yang
authors.affiliation: a Division of Hematology, Department of Internal Medicine , Seoul , Korea.
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage; D005260:Female; D005293:Ferritins / Q000097:blood*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008223:Lymphoma / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D057234:Preoperative Period; D012307:Risk Factors; D012720:Severity of Illness Index; D013852:Thiotepa / Q000008:administration & dosage; D019172:Transplantation Conditioning / Q000009:adverse effects; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D005293:Ferritins; D013852:Thiotepa; D002066:Busulfan
keywords: Autologous stem cell transplantation; conditioning regimen; malignant lymphoma; serum ferritin; sinusoidal obstructive syndrome