Retrospective analysis of veno-occlusive disease/sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation -a multicentre studyResearch in context
Summary: Background: Sinusoidal obstruction syndrome is a potentially fatal complication following hematopoietic cell transplantation, high-intensity chemotherapies and increasingly seen with calicheamicin based leukemia therapies. Paediatric specific European Society for Blood and Marrow Transplan...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-05-01
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| Series: | The Lancet Regional Health. Americas |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X24000553 |
| _version_ | 1797220217761300480 |
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| author | Dristhi Ragoonanan Hisham Abdel-Azim Aditya Sharma Saleh Bhar Jennifer McArthur Renee Madden April Rahrig Rajinder Bajwa Jian Wang Victoria Sun Mariah Wright Rebekah Lassiter Basirat Shoberu Jitesh Kawedia Sajad Jawad Khazal Kris Michael Mahadeo |
| author_facet | Dristhi Ragoonanan Hisham Abdel-Azim Aditya Sharma Saleh Bhar Jennifer McArthur Renee Madden April Rahrig Rajinder Bajwa Jian Wang Victoria Sun Mariah Wright Rebekah Lassiter Basirat Shoberu Jitesh Kawedia Sajad Jawad Khazal Kris Michael Mahadeo |
| author_sort | Dristhi Ragoonanan |
| collection | DOAJ |
| description | Summary: Background: Sinusoidal obstruction syndrome is a potentially fatal complication following hematopoietic cell transplantation, high-intensity chemotherapies and increasingly seen with calicheamicin based leukemia therapies. Paediatric specific European Society for Blood and Marrow Transplantation (pEBMT) diagnostic criteria have demonstrated benefit in single center studies compared to historic criteria. Yet, the extent to which they have been universally implemented remains unclear. Methods: We conducted a retrospective multi-centre study to examine the potential impact of the Baltimore, modified Seattle and pEBMT criteria on the incidence, severity, and outcomes of sinusoidal obstruction syndrome among paediatric hematopoietic cell transplantation patients. Findings: The incidence of sinusoidal obstruction syndrome in this cohort (n = 488) was higher by pEBMT (21.5%) vs historic modified Seattle (15.6%) and Baltimore (7.0%) criteria (p < 0.001). Application of pEBMT criteria identified 44 patients who were not previously diagnosed with sinusoidal obstruction syndrome. Overall, 70.5% of all patients diagnosed with sinusoidal obstruction syndrome ultimately developed very severe disease and almost half of diagnosed patients required critical care support. Overall survival was significantly lower in patients who were diagnosed with sinusoidal obstruction syndrome vs those who were not. Interpretation: Taken together, pEBMT criteria may be a sensitive method for prompter diagnosis of patients who subsequently develop severe/very severe sinusoidal obstruction syndrome. To our knowledge, this is the first multi-centre study in the United States (US) to demonstrate that pEBMT guidelines are associated with earlier detection of sinusoidal obstruction syndrome. Since early initiation of definitive treatment for sinusoidal obstruction syndrome has been associated with improved survival in paediatric patients and implementation of pEBMT criteria appears feasible in the US, universal adoption should facilitate prompter diagnosis and lead to improved outcomes of children with sinusoidal obstruction syndrome. Funding: None. |
| first_indexed | 2024-04-24T12:46:02Z |
| format | Article |
| id | doaj.art-a6460f7245804d2981330d6fd03ab969 |
| institution | Directory Open Access Journal |
| issn | 2667-193X |
| language | English |
| last_indexed | 2024-04-24T12:46:02Z |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj.art-a6460f7245804d2981330d6fd03ab9692024-04-07T04:36:58ZengElsevierThe Lancet Regional Health. Americas2667-193X2024-05-0133100728Retrospective analysis of veno-occlusive disease/sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation -a multicentre studyResearch in contextDristhi Ragoonanan0Hisham Abdel-Azim1Aditya Sharma2Saleh Bhar3Jennifer McArthur4Renee Madden5April Rahrig6Rajinder Bajwa7Jian Wang8Victoria Sun9Mariah Wright10Rebekah Lassiter11Basirat Shoberu12Jitesh Kawedia13Sajad Jawad Khazal14Kris Michael Mahadeo15Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Corresponding author. Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.Division of Transplant and Cell Therapy, Loma Linda University Cancer Center, Loma Linda, CA 92354, USAPediatric Blood and Marrow Transplant, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USATexas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USADivision of Critical Care, St Jude Children’s Research Hospital, Memphis, TN, USA; Division of Critical Care Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USADepartment of Bone Marrow Transplantation and Cellular Therapy, St Jude Children’s Research Hospital, Memphis, TN, USADepartment of Pediatrics, Division of Stem Cell Transplantation and Cellular Therapy, Riley Hospital for Children, Indianapolis, IN, USADivision of Hematology/Oncology/BMT, Nationwide Children’s Hospital, Columbus, OH, USADepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston TX 77030, USADepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston TX 77030, USADivision of Hematology/Oncology/BMT, Nationwide Children’s Hospital, Columbus, OH, USADivision of Critical Care, St Jude Children’s Research Hospital, Memphis, TN, USA; Division of Critical Care Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USADepartment of Pediatrics, Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USADepartment of Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston, TX, USADivision of Transplant and Cell Therapy, Loma Linda University Cancer Center, Loma Linda, CA 92354, USAPediatric Transplant and Cellular Therapy, Duke University, Durham, NC, USASummary: Background: Sinusoidal obstruction syndrome is a potentially fatal complication following hematopoietic cell transplantation, high-intensity chemotherapies and increasingly seen with calicheamicin based leukemia therapies. Paediatric specific European Society for Blood and Marrow Transplantation (pEBMT) diagnostic criteria have demonstrated benefit in single center studies compared to historic criteria. Yet, the extent to which they have been universally implemented remains unclear. Methods: We conducted a retrospective multi-centre study to examine the potential impact of the Baltimore, modified Seattle and pEBMT criteria on the incidence, severity, and outcomes of sinusoidal obstruction syndrome among paediatric hematopoietic cell transplantation patients. Findings: The incidence of sinusoidal obstruction syndrome in this cohort (n = 488) was higher by pEBMT (21.5%) vs historic modified Seattle (15.6%) and Baltimore (7.0%) criteria (p < 0.001). Application of pEBMT criteria identified 44 patients who were not previously diagnosed with sinusoidal obstruction syndrome. Overall, 70.5% of all patients diagnosed with sinusoidal obstruction syndrome ultimately developed very severe disease and almost half of diagnosed patients required critical care support. Overall survival was significantly lower in patients who were diagnosed with sinusoidal obstruction syndrome vs those who were not. Interpretation: Taken together, pEBMT criteria may be a sensitive method for prompter diagnosis of patients who subsequently develop severe/very severe sinusoidal obstruction syndrome. To our knowledge, this is the first multi-centre study in the United States (US) to demonstrate that pEBMT guidelines are associated with earlier detection of sinusoidal obstruction syndrome. Since early initiation of definitive treatment for sinusoidal obstruction syndrome has been associated with improved survival in paediatric patients and implementation of pEBMT criteria appears feasible in the US, universal adoption should facilitate prompter diagnosis and lead to improved outcomes of children with sinusoidal obstruction syndrome. Funding: None.http://www.sciencedirect.com/science/article/pii/S2667193X24000553Veno-occlusive diseaseHematopoietic cell transplantationPaediatricsSinusoidal obstruction syndrome |
| spellingShingle | Dristhi Ragoonanan Hisham Abdel-Azim Aditya Sharma Saleh Bhar Jennifer McArthur Renee Madden April Rahrig Rajinder Bajwa Jian Wang Victoria Sun Mariah Wright Rebekah Lassiter Basirat Shoberu Jitesh Kawedia Sajad Jawad Khazal Kris Michael Mahadeo Retrospective analysis of veno-occlusive disease/sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation -a multicentre studyResearch in context The Lancet Regional Health. Americas Veno-occlusive disease Hematopoietic cell transplantation Paediatrics Sinusoidal obstruction syndrome |
| title | Retrospective analysis of veno-occlusive disease/sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation -a multicentre studyResearch in context |
| title_full | Retrospective analysis of veno-occlusive disease/sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation -a multicentre studyResearch in context |
| title_fullStr | Retrospective analysis of veno-occlusive disease/sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation -a multicentre studyResearch in context |
| title_full_unstemmed | Retrospective analysis of veno-occlusive disease/sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation -a multicentre studyResearch in context |
| title_short | Retrospective analysis of veno-occlusive disease/sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation -a multicentre studyResearch in context |
| title_sort | retrospective analysis of veno occlusive disease sinusoidal obstruction syndrome in paediatric patients undergoing hematopoietic cell transplantation a multicentre studyresearch in context |
| topic | Veno-occlusive disease Hematopoietic cell transplantation Paediatrics Sinusoidal obstruction syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X24000553 |
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