Underdiagnosed veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) as a major cause of multi-organ failure in acute leukemia transplant patients: an analysis from the EBMT Acute Leukemia Working Party

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

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Alternative Links zum Volltext:DOIVerlag

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Details

Dokumentenart:	Artikel
Titel eines Journals oder einer Zeitschrift:	Bone Marrow Transplantation
Verlag:	SPRINGERNATURE
Ort der Veröffentlichung:	LONDON
Band:	56
Nummer des Zeitschriftenheftes oder des Kapitels:	4
Seitenbereich:	S. 917-927
Datum:	2021
Institutionen:	Medizin > Abteilung für Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation
Identifikationsnummer:	Wert Typ 10.1038/s41409-020-01135-3 DOI
Stichwörter / Keywords:	VERSUS-HOST-DISEASE; OCCLUSIVE DISEASE; MARROW-TRANSPLANTATION; CELL TRANSPLANTATION; EUROPEAN-SOCIETY; DIAGNOSIS; BLOOD; LIVER;
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Ja
Dokumenten-ID:	50611

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Zusammenfassung

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 ...

Zusammenfassung

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.

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Metadaten zuletzt geändert: 11 Okt 2021 13:10

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