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Sinusoidal obstruction syndrome: a warning about autologous stem cell transplantation preceded by regimens containing oxaliplatin

Bone Marrow Transplantation volume 55, pages 1834–1836 (2020)Cite this article

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Autologous stem cell transplantation (ASCT) is a cornerstone of lymphoma therapeutics, especially in the relapse setting. BEAM (carmustine, etoposide, cytarabine, and melphalan) is the most widely used conditioning regimen with a low rate of transplant mortality. Bendamustine has occasionally been used in France as a substitute for carmustine during a period of shortage (“BendaEAM”). Sinusoidal obstruction syndrome (SOS) is a potentially life-threatening complication, rarely observed after ASCT. In an EBMT study of 1010 patients, SOS occurred in less than 1% after BEAM in patients who had a normal level of AST before ASCT and a Karnofsky scale of less than 90% [1]. Six SOS were observed in the Henri Mondor University Hospital during the last 10 years (incidence 4.1% among 145 ASCTs for lymphoma). In Curie Institute in Paris, an incidence of 3/46 (6.5%) was reported for six years. After these cases and several reports in other centers, a national retrospective study was initiated.

After a national alert spread through our cooperative group (LYSA) and the French Health Agency (ANSM), data from ASCT patients were collected focusing on history of lymphoma, SOS risk factors [2] (i.e., active viral hepatitis, cirrhosis, tumoral infiltration, liver function, chemotherapy, concomitant drugs…), conditioning, diagnostic criteria for SOS (based on the EBMT classification [3] or liver biopsy), treatment of SOS, and outcomes. Under French law, retrospective studies using data from medical charts required only authorization of the National Commission for Data Protection and Liberties (CNIL) (authorization number 2212876). Differential diagnoses (infections, treatment toxicity) were eliminated. Some cases have already been reported [4, 5]. Six cases came from clinical studies: three from BIBLOS (NCT02055924), two from BENEFIT (NCT02008006), and one from LYMA101 (NCT02896582).

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Authors and Affiliations

  1. Lymphoid Malignancies Unit, Henri Mondor University Hospital, Créteil, France

    Pierre-Edouard Debureaux, Corinne Haioun & Jehan Dupuis

  2. Pharmacy Unit, Henri Mondor University Hospital, Créteil, France

    Delphine Le Febvre de Nailly

  3. Hematology Department, Oncology Institute of Loire, Saint Priest en Jarez, France

    Emmanuelle Tavernier

  4. Hematology Department, Curie Institute, Paris, France

    Manel Bedoui & Frederique Kuhnowski

  5. Hematology Department, Cochin Hospital, Paris, France

    Jerome Tamburini

  6. Hematology Department, CHU Strasbourg, Strasbourg, France

    Luc-Matthieu Fornecker

  7. Hematology Department, Henri Becquerel Cancer Centre, Rouen, France

    Vincent Camus

  8. Hematology Department, Necker University Hospital, Paris, France

    David Sibon

  9. Hematology Department, Angers Hospital, Angers, France

    Marie-Pierre Moles

  10. Department of Hematology, Institut Curie - Hôpital René Huguenin, Saint-Cloud, France

    Sylvie Glaisner

  11. Hepatology and Gastro-Enterology Department, Henri Mondor University Hospital, Créteil, France

    Jean Philippe Richardet

  12. Radiology and Medical Imaging Department, Henri Mondor University Hospital, Créteil, France

    Sebastien Mule

  13. Paris Est-Créteil University, Créteil, France

    Sebastien Mule & Corinne Haioun

  14. Department of Pathology, Henri Mondor University Hospital, Créteil, France

    Julien Calderaro

  15. Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Paul Brousse Hospital, Villejuif, France

    Daniel Azoulay

  16. Department of Clinical Immunology, Saint Louis Hospital, Paris, France

    Jehane Fadlallah

Authors
  1. Pierre-Edouard Debureaux
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  17. Corinne Haioun
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  18. Jehan Dupuis
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Correspondence to Pierre-Edouard Debureaux.

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Haioun Corinne received Honoraria from Roche, Celgene, Amgen, Janssen, Gilead, Sciences, and Takeda.

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Debureaux, PE., Febvre de Nailly, D.L., Tavernier, E. et al. Sinusoidal obstruction syndrome: a warning about autologous stem cell transplantation preceded by regimens containing oxaliplatin. Bone Marrow Transplant 55, 1834–1836 (2020). https://doi.org/10.1038/s41409-020-0796-6

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