{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T07:17:23Z","timestamp":1785655043802,"version":"3.56.0"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Veno\u2010occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a life\u2010threatening complications of hematopoietic cell transplantation (HCT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied the impact of early defibrotide (DF) therapy on the outcomes of pediatric patients with VOD\/SOS after transplantation, focusing on recent immunotherapies. A total of 111 pediatric patients who underwent HCT for malignant disease between February 2017 and March 2023 at Kyushu University Hospital were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 111 patients of less than 20\u00a0years of age who underwent HCT for malignancy at a single institution between 2017 and 2023, VOD\/SOS occurred in 25 (23%) patients. VOD\/SOS developed more frequently in the post\u2010DF era (2020\u20132023, <jats:italic>n<\/jats:italic>\u00a0=\u00a058) than in the pre\u2010DF era (31% vs. 13%, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.04). The proportion of patients with relapsed\/refractory acute lymphoblastic leukemia (ALL) was higher in the post\u2010DF era than in the pre\u2010DF era (44% vs. 8%, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.04). Early DF therapy that was started at two European Society for Blood and Marrow Transplantation diagnostic criteria reduced the severity of VOD\/SOS (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.01) in comparison to non\u2010early therapy started at less than two criteria. A multivariate analysis indicated that a history of cytokine release syndrome (odds ratio [OR]\u00a0=\u00a010.4, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.01) and juvenile myelomonocytic leukemia (OR\u00a0=\u00a08.98, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.04), but not an endothelial activation and stress index (EASIX) score of greater than 0.85, were independent risk factors for VOD\/SOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early DF therapy improves the severity and survival outcomes of post\u2010transplant VOD\/SOS in children. However, its incidence is increasing in the era of immunotherapy for progressive diseases.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31331","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T05:19:27Z","timestamp":1726636767000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Early defibrotide therapy and risk factors for post\u2010transplant veno\u2010occlusive disease\/sinusoidal obstruction syndrome in childhood"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2120-3440","authenticated-orcid":false,"given":"Hironori","family":"Goto","sequence":"first","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"},{"name":"Department of Pediatrics Oita University Faculty of Medicine  Oita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Utako","family":"Oba","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2216-8368","authenticated-orcid":false,"given":"Tamaki","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5313-7161","authenticated-orcid":false,"given":"Shunsuke","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Shimo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satomi","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Pediatrics NHO Kumamoto Medical Center  Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2912-1335","authenticated-orcid":false,"given":"Yusuke","family":"Takase","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Biomedical Sciences Nagasaki University  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9409-2802","authenticated-orcid":false,"given":"Wakako","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-1088","authenticated-orcid":false,"given":"Souichi","family":"Suenobu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Oita University Faculty of Medicine  Oita Japan"},{"name":"National Hospital Organization Nishibeppu National Hospital  Oita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8831-1991","authenticated-orcid":false,"given":"Kenji","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Oita University Faculty of Medicine  Oita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhki","family":"Koga","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"},{"name":"Department of Pediatrics National Hospital Organization Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shouichi","family":"Ohga","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-10-676924"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198712000-00011"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-4-199302150-00003"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2017.161"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-020-0918-1"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.238790"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2024.100728"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21113886"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021005410"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-014-0242-x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403004"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V100.1.334"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15267"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2004.01.002"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61938-7"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29641"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-023-02161-7"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(23)00011-X"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.05.025"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705835"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2015.09.024"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2022.01.013"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2022.103372"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509277"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2006.07.005"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.09.027"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2022.05.001"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1701994"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2017.1370372"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2020.03.011"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16557"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-021-01265-2"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-021-01390-y"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020002007"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003455"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023009961"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.2991\/chi.k.210117.001"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.01973"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.52"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-018-0426-8"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-022-01900-6"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-021-03137-3"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1249958"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-960X(03)00002-X"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.31331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T03:46:00Z","timestamp":1744256760000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.31331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,17]]},"references-count":44,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/pbc.31331"],"URL":"https:\/\/doi.org\/10.1002\/pbc.31331","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,17]]},"assertion":[{"value":"2024-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e31331"}}