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Validation of treatment outcomes according to revised severity criteria from European Society for Blood and Marrow Transplantation (EBMT) for sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD)

Bone Marrow Transplantation volume 54, pages 1361–1368 (2019)Cite this article

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Abstract

Traditional severity criteria of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) were determined retrospectively but found inappropriate for therapeutic decisions. Data of 203 patients with SOS/VOD were collected according to the modified Seattle diagnostic criteria and were analyzed for validation of the revised severity criteria recently proposed from European Society for Blood and Marrow Transplantation (EBMT). According to the traditional severity criteria, none of the patients were mild grade, while 63.1% were moderate and 36.9% were severe grade. However, according to the revised EBMT criteria, the majority of patients (63.1%) were very severe, 18.2% were severe, 12.8% were moderate, and 5.9% were mild grade. The 100-day overall survival (OS) of mild, moderate, severe and very severe groups was 83.3, 84.3, 94.6, and 58.6%, respectively. Very severe SOS/VOD showed a significantly lower OS than the others (58.6 vs. 89.3%, p < 0.0001). The 100-day transplantation-related mortality was 25.2% in the entire cohort; 8.3% in mild, 8.0% in moderate, 2.7% in severe, and 36.7% in very severe SOS/VOD (p < 0.0001). The very severe grade newly classified by the revised EBMT criteria accounted for the majority of SOS/VOD associated with worse 100-day OS. Therefore, intervention should be applied at the latest for moderate to severe SOS/VOD before deterioration.

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Acknowledgements

The authors acknowledge Yun Jung Choi, PhD., Rph. and Jeonghee Kim, PhD. from HANDOK Inc. for the coordination of data collection and statistical analysis supervised by the investigators.

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  1. These authors contributed equally: Jae-Ho Yoon, Keon Hee Yoo

Authors and Affiliations

  1. Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Jae-Ho Yoon & Jong Wook Lee

  2. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Keon Hee Yoo & Ki Woong Sung

  3. Department of Hematology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Chul Won Jung

  4. Division of Hematology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jin Seok Kim

  5. Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Seung Min Hahn

  6. Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Cancer Research Institute, Seoul, Republic of Korea

    Hyoung Jin Kang

  7. Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Je-Hwan Lee

  8. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Ho Joon Im

  9. Department of Hematology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea

    Jae-Sook Ahn

  10. Department of Pediatrics, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea

    Hoon Kook

  11. Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Bin Cho

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Contributions

J-H.Y. designed the study, enrolled patients, collected and analyzed data, and wrote the manuscript; K.H.Y., K.W.S., C.W.J., J.S.K., S.M.H., H.J.K., J-H.L., H.J.I., H.K., J.-S.A., and B.C., analyzed data, enrolled patients; J.W.L. designed and conducted the study, enrolled patients, analyzed data, and wrote the manuscript; and all authors approved the final version of the manuscript.

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Correspondence to Jong Wook Lee.

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Yoon, JH., Yoo, K.H., Sung, K.W. et al. Validation of treatment outcomes according to revised severity criteria from European Society for Blood and Marrow Transplantation (EBMT) for sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD). Bone Marrow Transplant 54, 1361–1368 (2019). https://doi.org/10.1038/s41409-019-0492-6

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