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改良 EBMT 诊断和严重程度标准 2023 年在窦状隙阻塞综合征/静脉阻塞性疾病中的应用。

Utility of the refined EBMT diagnostic and severity criteria 2023 for sinusoidal obstruction syndrome/veno-occlusive disease.

机构信息

Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan.

Department of Oncology and Hematology, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Japan.

出版信息

Bone Marrow Transplant. 2024 Apr;59(4):518-525. doi: 10.1038/s41409-024-02215-4. Epub 2024 Jan 29.

DOI:10.1038/s41409-024-02215-4
PMID:38287083
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10994840/
Abstract

Sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a life-threatening complication of hematopoietic stem cell transplantation (HSCT). Early diagnosis of SOS/VOD is associated with improved clinical outcomes. In 2023, the refined European Society for Blood and Marrow Transplantation diagnostic and severity criteria (refined EBMT criteria 2023) have been advocated. The revision has introduced new diagnostic categories, namely; probable, clinical, and proven SOS/VOD. In addition, the Sequential Organ Failure Assessment (SOFA) score has been newly incorporated into the SOS/VOD severity grading. We performed a retrospective analysis to evaluate the utility of these criteria. We analyzed 161 cases who underwent allogeneic HSCT. We identified 53 probable, 23 clinical, and 4 proven SOS/VOD cases. Probable SOS/VOD was diagnosed a median of 5.0 days earlier (interquartile range: 2-13 days, P < 0.001) than that of clinical SOS/VOD. The development of probable SOS/VOD alone was associated with a significantly inferior survival proportion compared to non-SOS/VOD (100-day survival, 86.2% vs. 94.3%, P = 0.012). The SOFA score contributed to the prediction of prognosis. Consequently, the refined EBMT criteria 2023 demonstrated the utility of SOS/VOD diagnosis and severity grading. Further investigations and improvements in these criteria are warranted.

摘要

窦阻塞综合征/静脉阻塞病（SOS/VOD）是造血干细胞移植（HSCT）的一种危及生命的并发症。早期诊断 SOS/VOD 与改善临床结局相关。2023 年，欧洲血液和骨髓移植学会（EBMT）提出了细化的诊断和严重程度标准（2023 年细化 EBMT 标准）。修订版引入了新的诊断类别，即可能的、临床的和确诊的 SOS/VOD。此外，序贯器官衰竭评估（SOFA）评分已被新纳入 SOS/VOD 严重程度分级。我们进行了一项回顾性分析，以评估这些标准的实用性。我们分析了 161 例接受异基因 HSCT 的患者。我们确定了 53 例可能的、23 例临床的和 4 例确诊的 SOS/VOD 病例。可能的 SOS/VOD 比临床 SOS/VOD 提前平均诊断 5.0 天（四分位距：2-13 天，P<0.001）。与非 SOS/VOD 相比，单独发生可能的 SOS/VOD 与显著较低的生存比例相关（100 天生存率，86.2%比 94.3%，P=0.012）。SOFA 评分有助于预测预后。因此，2023 年细化的 EBMT 标准证明了 SOS/VOD 诊断和严重程度分级的实用性。需要进一步研究和改进这些标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/40c4a0d1d797/41409_2024_2215_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/db796dd5c3eb/41409_2024_2215_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/54462e1c551c/41409_2024_2215_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/e1f1ed8117db/41409_2024_2215_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/40c4a0d1d797/41409_2024_2215_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/db796dd5c3eb/41409_2024_2215_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/54462e1c551c/41409_2024_2215_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/e1f1ed8117db/41409_2024_2215_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc0/10994840/40c4a0d1d797/41409_2024_2215_Fig4_HTML.jpg

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