Analysis of early onset VOD post allo-SCT in younger and older adults
Marcoux C, Saliba RM, Wallis W, et al. Incidence and Risk Factors of Early Onset VOD/SOS Differ in Younger vs Older Adults After Stem Cell Transplantation. Blood Advances. 2024; (doi: 10.1182/bloodadvances.2023011233).
All patients undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT) have the potential to develop veno-occlusive disease (VOD), but researchers have found the incidence and risk factors of early onset VOD vary by patient age. Adults 18-25 years old have greater risk than those aged >25 years, based on a retrospective analysis of 1,561 patients. In the sample, 16.8% in the younger category presented with VOD compared with 3.8% in the older group. Analysis also identified unique age-dependent predictors of VOD, the most significant of which for those aged 18-25 years were disease-related factors and exposure to prior lines of chemotherapy. For adults >25 years, hepatic markers such as a higher bilirubin levels at baseline and prior gemtuzumab treatment were signals for increased rates of VOD. The study also offered clarity on whether VOD is affected by the introduction of post-transplant cyclophosphamide (PTCy) in recent years as prevention against another allo-SCT complication: graft-versus-host disease (GVHD). While 72% of the participants underwent PTCy, the data showed they were at no greater risk for VOD than transplant recipients who received a different GVHD prophylaxis.