title: Sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation: Incidence, risk factors and outcomes.
abstract: 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.
authors.affiliation: Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yakushijin
authors.affiliation: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.|Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Atsuta
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Doki
authors.affiliation: Department of Hematology, Chiba Aoba Municipal Hospital, Chiba, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Yokota
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kanamori
authors.affiliation: Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Department of Hematology, Chiba University Hospital, Chiba, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Ohwada
authors.affiliation: Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Miyamura
authors.affiliation: Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nawa
authors.affiliation: Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kurokawa
authors.affiliation: Department of Hematology, Hyogo Cancer Center, Hyogo, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Mizuno
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Hematology/Oncology, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Onizuka
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Taguchi
authors.affiliation: Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ichinohe
authors.affiliation: Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yabe
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Morishima
authors.affiliation: Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D019337:Hematologic Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006504:Hepatic Veno-Occlusive Disease / Q000097:blood / Q000209:etiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate