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To assist clinicians to promptly identify HSOS, the European Society for Blood and Marrow Transplantation has proposed pediatric HSOS diagnostic criteria which emphasize unexplained consumptive and transfusion\u2010refractory thrombocytopenia. To highlight the importance of these \u201cbellwether\u201d early signs of HSOS and the efficacy of pre\u2010emptive treatment with defibrotide, we describe the case of a child with a right 11th rib primitive neuroectodermal tumor who developed HSOS following focal radiotherapy and actinomycin\u2010D treatment.<\/jats:p>","DOI":"10.1002\/pbc.27036","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T12:02:35Z","timestamp":1521115355000},"source":"Crossref","is-referenced-by-count":4,"title":["\u201cPre\u2010emptive strike\u201d\u2014the case for early treatment of hepatic sinusoidal obstruction syndrome with defibrotide"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4380-4124","authenticated-orcid":false,"given":"Revathi","family":"Rajagopal","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology Princess Margaret Hospital for Children  Perth Australia"},{"name":"Pediatric Hematology and Oncology Unit Department of Pediatrics University of Malaya  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne B.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Princess Margaret Hospital for Children  Perth Australia"},{"name":"Telethon Kids Cancer Centre Telethon Kids Institute University of Western Australia  Perth Australia"},{"name":"Division of Paediatrics School of Medicine University of Western Australia  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas G.","family":"Gottardo","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Princess Margaret Hospital for Children  Perth Australia"},{"name":"Telethon Kids Cancer Centre Telethon Kids Institute University of Western Australia  Perth Australia"},{"name":"Division of Paediatrics School of Medicine University of Western Australia  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,3,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/08880018.2010.535118"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.2.268"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(01)00097-1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04578.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e3182a8f352"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22202"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.2.527"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22841"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2016.096"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840040121"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198712000-00011"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2017.161"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12558"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950250613"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-012-1128-4"},{"key":"e_1_2_7_17_1","first-page":"967","article-title":"Veno\u2010occlusive disease of the liver induced by low\u2010dose cyclophosphamide","volume":"7","author":"Modzelewski JR","year":"1994","journal-title":"Mod Pathol"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950250614"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2016.130"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200411000-00020"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704329"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.02.009"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2016.07.001"}],"container-title":["Pediatric Blood &amp; 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