Autotaxin is a Potential Predictive Marker for the Development of Veno-occlusive Disease/sinusoidal Obstruction Syndrome After Allogeneic Hematopoietic Cell Transplantation

Overview

Journal Ann Hematol

Specialty Hematology

Date 2024 Mar 18

PMID 38494552

Authors

Kazuya Takemura

Mika Nakamae

Hiroshi Okamura

Kazuki Sakatoku

Kentaro Ido

Yosuke Makuuchi

Masatomo Kuno

Teruhito Takakuwa

Asao Hirose

Mitsutaka Nishimoto

Yasuhiro Nakashima

Hideo Koh

Koji Igarashi

Hiroshi Kubota

Masayuki Hino

Hirohisa Nakamae

Affiliations

Soon will be listed here.

Abstract

Veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is a life-threatening complication after allogeneic hematopoietic cell transplantation (allo-HCT), and stratification of the high-risk group before transplantation is significant. Serum autotaxin (ATX) levels have been reported to increase in patients with liver fibrosis caused by metabolic inhibition from liver sinusoidal endothelial cells. Considering that the pathophysiology of VOD/SOS begins with liver sinusoidal endothelial cell injury, an increase in serum ATX levels may precede the onset of VOD/SOS. A retrospective study with 252 patients, including 12 patients with VOD/SOS, who had received allo-HCT was performed. The cumulative incidence of VOD/SOS was higher in the group with serum ATX levels before conditioning (baseline ATX) above the upper reference limit (high ATX group, p < 0.001), and 1-year cumulative incidences were 22.7% (95% confidence interval [95%CI], 3.1-42.4%) and 3.5% (95%CI, 1.1-5.8%), respectively. In the multivariate analysis, elevated baseline ATX was identified as an independent risk factor for VOD/SOS development and showed an additive effect on the predictive ability of known risk factors. Furthermore, the incidence of VOD/SOS-related mortality was greater in the high ATX group (16.7% vs. 1.3%; p = 0.005). Serum ATX is a potential predictive marker for the development of VOD/SOS.

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