Onkológia 5/2025
Sinusoidal obstruction syndrome after hematopoietic stem cell transplantation: pathogenesis, diagnosis, and treatment options
Sinusoidal Obstruction Syndrome (SOS), also known as hepatic veno-occlusive disease, is a severe complication of both allogeneic and autologous hematopoietic stem cell transplantation. Its pathogenesis involves damage to hepatic sinusoids caused by the toxic effects of chemotherapeutic and immunosuppressive agents, leading to endothelial dysfunction, inflammatory responses, and subsequent venous obstruction. Clinical manifestations include hepatomegaly, ascites, jaundice, and weight gain, with severe cases potentially progressing to multiorgan failure with high mortality. Diagnosis is based on the modified Seattle and Baltimore criteria, with imaging techniques such as Doppler ultrasonography playing a key role in confirming the condition. Management of SOS relies on preventive strategies (e.g., defibrotide administration) and supportive care, including close monitoring and treatment of hepatic and circulatory function. Despite advances in diagnostic and therapeutic approaches, SOS remains a serious complication associated with significant morbidity and mortality, highlighting the need for further research into personalized prevention and treatment. This review article summarizes current knowledge on the pathogenesis, diagnosis, and treatment options for SOS, with an emphasis on emerging clinical approaches.
Keywords: sinusoidal obstruction syndrome, hematopoietic stem cell transplantation, pathogenesis, diagnosis, treatment
