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Transplant Toxicities

Sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation: Incidence, risk factors and outcomes

Bone Marrow Transplantation volume 51, pages 403–409 (2016)Cite this article

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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.

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Acknowledgements

We appreciate the contributions of all of the physicians and data managers at the centers who provided important data regarding transplantation to the JSHCT, the Japan Marrow Donor Program (JMDP) and the Japan Cord Blood Bank Network (JCBBN). We also thank all of the members of the TRUMP committees of the JSHCT, JMDP and JCBBN for their dedication and contribution to data management.

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Authors and Affiliations

  1. Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    K Yakushijin

  2. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Y Atsuta

  3. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Y Atsuta

  4. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    N Doki

  5. Department of Hematology, Chiba Aoba Municipal Hospital, Chiba, Japan

    A Yokota

  6. Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan

    H Kanamori

  7. Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    T Miyamoto

  8. Department of Hematology, Chiba University Hospital, Chiba, Japan

    C Ohwada

  9. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    K Miyamura

  10. Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan

    Y Nawa

  11. Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan

    M Kurokawa

  12. Department of Hematology, Hyogo Cancer Center, Hyogo, Japan

    I Mizuno

  13. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    T Mori

  14. Department of Hematology/Oncology, Tokai University School of Medicine, Kanagawa, Japan

    M Onizuka

  15. Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Hospital, Nagasaki, Japan

    J Taguchi

  16. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    T Ichinohe

  17. Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan

    H Yabe

  18. Division of Epidemiology and Prevention, Aichi Cancer Center Research, Nagoya, Japan

    Y Morishima

  19. Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    K Kato

  20. Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan

    R Suzuki

  21. Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    T Fukuda

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  1. K Yakushijin
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Correspondence to K Yakushijin.

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Yakushijin, K., Atsuta, Y., Doki, N. et al. Sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation: Incidence, risk factors and outcomes. Bone Marrow Transplant 51, 403–409 (2016). https://doi.org/10.1038/bmt.2015.283

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