Progress in the Diagnosis and Treatment of Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome After Allogeneic Hematopoietic Stem Cell Transplantation

Ziyi Bai

doi:10.54097/fz874484

Authors

Ziyi Bai

DOI:

https://doi.org/10.54097/fz874484

Keywords:

Allogeneic Hematopoietic Stem Cell Transplantation, Sinusoidal Obstruction Syndrome, Diagnostic Criteria, Preventive Measure

Abstract

In recent years, as the technology of haploidentical transplantation has become increasingly mature, allogeneic hematopoietic stem cell transplantation (allo-HSCT) has played an increasingly important role in the treatment of hematological diseases. However, veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) as a serious complication after allo-HSCT, has attracted much attention due to its extremely high mortality rate. This review aims to comprehensively explore the latest research progress of VOD/SOS after allo-HSCT, including epidemiological characteristics, pathogenesis, diagnostic criteria, prevention strategies and treatment regimens. First, the review summarizes the epidemiological features of VOD/SOS, pointing out that the incidence of the disease has shown a downward trend in recent years. In terms of pathogenesis, it emphasizes the core role of endothelial cell injury and the new progress in the aspects of intestinal microbiota and genetic susceptibility. Subsequently, the article reviews the updates of VOD/SOS diagnostic criteria in recent years, focusing on the quantification and clarification of the ambiguous parts in the traditional criteria, such as the optimal definition of hepatomegaly and ascites, the imaging characteristics of VOD/SOS, etc., making them more applicable in clinical practice, and further explores the new diagnostic technologies such as liver stiffness measurement and serological biomarkers. In terms of prevention, the article mainly evaluates the efficacy and safety of common prophylactic drugs for VOD/SOS. In terms of treatment, the article discusses the role of defibrotide in the treatment of VOD/SOS, and emphasizes the importance of supportive care and intensive monitoring. Finally, the review points out that although significant progress has been made in the diagnosis and treatment of VOD/SOS, further research is still needed to explore its complex pathophysiological mechanisms, to develop more specific and sensitive diagnostic criteria, and to devise more effective prevention and treatment strategies.

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