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It is more common in children, with an incidence of approximately 20% compared to 10% in adult patients. While the Hokkaido ultrasonography (US)-based scoring system (HokUS-10 and HokUS-6) has proven effective in diagnosing SOS\/VOD in adults, its utility in children remains uncertain. This study evaluated the utility of the HokUS-10\/6 scoring systems in diagnosing pediatric SOS\/VOD (pSOS\/VOD) in a cohort of 99 patients, including 13 diagnosed with pSOS\/VOD. Hyperbilirubinemia (&gt;\u20092\u00a0mg\/dL) was observed in only three patients (23%), whereas transfusion-refractory thrombocytopenia, hepatomegaly, and ascites were observed in all 13 patients. When the cutoff values for HokUS-10 and HokUS-6 scores were set at 4 and 2, the respective areas under the curve were 0.977 and 0.957. The sensitivity and specificity were 100% and 80% for HokUS-10, and 77% and 97% for HokUS-6, respectively. The simplified HokUS-6 may be a practical tool for diagnosing pSOS\/VOD when use of the HokUS-10 scoring system is not feasible. HokUS-10\/6 is important for early detection of pSOS\/VOD during regular examinations and plays a valuable role in the diagnosis of clinical pSOS\/VOD.<\/jats:p>","DOI":"10.1007\/s12185-025-03995-1","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T06:01:29Z","timestamp":1745647289000},"page":"434-443","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultrasonographic scoring system for SOS\/VOD in pediatric hematopoietic stem cell transplant recipients"],"prefix":"10.1007","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8406-7311","authenticated-orcid":false,"given":"Mutsumi","family":"Nishida","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinsuke","family":"Hirabayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahito","family":"Iwai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megumi","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Kudo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satomi","family":"Omotehara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsunori","family":"Horie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Sakano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukayo","family":"Terashita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Manabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Teshima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"issue":"2","key":"3995_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.5500\/wjt.v2.i2.27","volume":"2","author":"DK Cheuk","year":"2012","unstructured":"Cheuk DK. 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Atsushi Manabe is an editor of International Journal of Hematology. And he has received honoraria from Novartis, Servier, Ohara, Chugai, Novo Nordisk, Bayer, Nippon Shinyaku, Meiji Seika, Astellas, CSL Behring, Daiichi Sakyo, AbbVie, Miyarisan, Amgen, Janssen, Sumitomo, Takeda, Asahi Kasei, and Sanofi. Takanori Teshima has received research grants and speaker fees from Chugai, Kyowa Kirin, Nippon Shinyaku, Sumitomo Pharma and Astellas; received research grants from Fuji Pharma, Asahi Kasei Pharma, Eisai, Ono, Shionogi, Priothera SAS and Luca Science; received speaker fees from AbbVie, Novartis, Bristol-Myers Squibb, Merck Sharp & Dohme, Celgene and Janssen; and participated on a Data Safety Monitoring Board or Advisory Board at Novartis, Meiji Seika Pharma, Daiichi Sankyo, Asahi Kasei Pharma, Astellas, AstraZeneca, Takeda, Janssen, Roche Diagnostics, Sumitomo Pharma, Celgene and Sanofi. The remaining authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}]}}