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<p>Hepatic sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) may occur after allo-HSCT. This retrospective study of 793 allo-HSCT performed in adult patients analyzes the impact of clinical risk factors and the EASIX score on the incidence and outcomes of SOS/VOD using Real-World data (GETH-TC registry). Severity and clinical risk factors were defined according to the EBMT-2023 criteria. The EASIX score was calculated at three time points after allo-HSCT (EASIX-day 0, d + 7, d + 14). SOS/VOD developed in 79 patients (10%), at a median time of 15 days. The cumulative incidence of SOS/VOD at 30 and 90 days post-HSCT was 8.58% and 9.97%, respectively. Defibrotide was used in 44 patients (56%) who developed SOS/VOD. Patients with SOS/VOD experienced an increased risk of NRM (HR 5.56; <i>p</i> &lt; 0.001). Multivariate analysis confirmed the prognostic value for SOS/VOD incidence of second or subsequent HSCT, use of parenteral nutrition, high tacrolimus/sirolimus levels, INR &gt; 1.5 before SOS, as well as day 0 EASIX ≥ 2 (sHR 1.67; <i>p</i> = 0.036), d + 7 EASIX ≥ 6 (sHR 2.86; <i>p</i> &lt; 0.001), and d + 14 EASIX ≥ 6 (sHR 2.87; <i>p</i> = 0.003). In conclusion, SOS/VOD incidence is similar to previous series and significantly impacts NRM. EASIX score was validated as a risk factor of SOS/VOD.</p>

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Incidence, clinical risk factors, and biomarkers of SOS/VOD following allogeneic HSCT in adults. A real-life study by the Spanish group of HSCT and cell therapy (GETH-TC).

  • 期刊论文

  • 发表日期：

    2026年7月17日

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  • Ariadna Pérez-Martínez,
  • Mónica Cabrero,
  • Juan Montoro,
  • Miriam Sánchez-Escamilla,
  • María Ángeles Cuesta,
  • Valle Gómez-García de Soria,
  • Pedro González-Sierra,
  • Karem Humala,
  • Oriana López-Godino,
  • Alejandro Luna de Abia,
  • Lucía López-Corral,
  • Jaime Sanz,
  • María Jesús Pascual,
  • José Luis Piñana,
  • Arancha Bermúdez,
  • José María Bellón,
  • Silvia Filaferro,
  • Guillermo Orti,
  • Pascual Balsalobre,
  • Carlos Solano

摘要

Hepatic sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) may occur after allo-HSCT. This retrospective study of 793 allo-HSCT performed in adult patients analyzes the impact of clinical risk factors and the EASIX score on the incidence and outcomes of SOS/VOD using Real-World data (GETH-TC registry). Severity and clinical risk factors were defined according to the EBMT-2023 criteria. The EASIX score was calculated at three time points after allo-HSCT (EASIX-day 0, d + 7, d + 14). SOS/VOD developed in 79 patients (10%), at a median time of 15 days. The cumulative incidence of SOS/VOD at 30 and 90 days post-HSCT was 8.58% and 9.97%, respectively. Defibrotide was used in 44 patients (56%) who developed SOS/VOD. Patients with SOS/VOD experienced an increased risk of NRM (HR 5.56; p < 0.001). Multivariate analysis confirmed the prognostic value for SOS/VOD incidence of second or subsequent HSCT, use of parenteral nutrition, high tacrolimus/sirolimus levels, INR > 1.5 before SOS, as well as day 0 EASIX ≥ 2 (sHR 1.67; p = 0.036), d + 7 EASIX ≥ 6 (sHR 2.86; p < 0.001), and d + 14 EASIX ≥ 6 (sHR 2.87; p = 0.003). In conclusion, SOS/VOD incidence is similar to previous series and significantly impacts NRM. EASIX score was validated as a risk factor of SOS/VOD.