{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:15:54Z","timestamp":1788250554437,"version":"build-2803163510"},"reference-count":38,"publisher":"American Society for Clinical Investigation","issue":"10","license":[{"start":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:00:00Z","timestamp":1684713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,22]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Currently, no laboratory tests exist to stratify for the risk of developing sinusoidal obstruction syndrome (SOS), an early endothelial complication after hematopoietic cell transplantation (HCT). Risk biomarkers of SOS have not been verified in a prospective cohort accounting for differences between practices across institutions. Herein, we aimed to define risk groups for SOS occurrence using 3 proteins: L-ficolin, hyaluronic acid (HA), and stimulation 2 (ST2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Between 2017 and 2021, we prospectively accrued 80 pediatric patients across 4 US centers. Biomarkers were tested by ELISA blind to patient groupings and associated with SOS incidence on day 35 after HCT, and overall survival (OS) on day 100 after HCT. Cutpoints were identified using retrospective cohorts and applied to the prospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Combination of the 3 biomarkers measured on day 3 after HCT in the prospective cohort provided 80% (95% CI 55%\u2013100%) sensitivity and 73% (95% CI 62%\u201383%) specificity for risk of SOS occurrence. Patients with low L-ficolin were 9 times (95% CI 3\u201332) more likely to develop SOS, while patients with high HA and ST2 were 6.5 (95% CI 1.9\u201322.0) and 5.5 (95% CI 2.3\u201313.1) times more likely to develop SOS. These 3 markers also predicted worse day 100 OS \u2014 L-ficolin: HR, 10.0 (95% CI 2.2\u201345.1),\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0002; HA: HR, 4.1 (95% CI 1.0\u201316.4),\n                      <jats:italic>P<\/jats:italic>\n                      = 0.031; and ST2: HR, 3.9 (95% CI 0.9\u201316.4),\n                      <jats:italic>P<\/jats:italic>\n                      = 0.04.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>L-ficolin, HA, and ST2 levels measured as early as 3 days after HCT improved risk stratification for SOS occurrence and OS and may guide risk-adapted preemptive therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT03132337.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>FUNDING<\/jats:title>\n                    <jats:p>NIH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1172\/jci.insight.168221","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T12:02:43Z","timestamp":1681819363000},"source":"Crossref","is-referenced-by-count":6,"title":["Prospective assessment of risk biomarkers of sinusoidal obstruction syndrome after hematopoietic cell transplantation"],"prefix":"10.1172","volume":"8","author":[{"given":"Yan","family":"Han","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Bidgoli","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany P.","family":"DePriest","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5479-5919","authenticated-orcid":true,"given":"Alejandra","family":"M\u00e9ndez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadijeh","family":"Bijangi-Vishehsaraei","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6159-9510","authenticated-orcid":true,"given":"Evelio D.","family":"Perez-Albuerne","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s National Medical Center, Washington, DC, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Krance","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Children\u2019s Hospital, and Baylor College of Medicine, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Renbarger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi L.","family":"Skiles","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, 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USA."},{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, 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