Sinusoidal Obstruction Syndrome (SOS) in Multiple Myeloma with Renal Failure. (3rd December 2018)

• Record Type: Journal Article
• Authors: Shah, Urvi A.; Viswanathan, Sengottuvel; Agarwal, Beamon; Shastri, Aditi; Mantzaris, Ioannis; Janakiram, Murali; Kornblum, Noah; Braunschweig, Ira; Verma, Amit; Shi, Yang; Reinus, John; Derman, Olga
• Other Names: Ribera Josep M. Academic Editor.
• Is Part Of: Case reports in oncological medicine. Volume 2018(2018)
• Publication Date: 2018-12-03
• Subjects: Oncology -- Periodicals; Tumors -- Periodicals; Oncology -- Case studies -- Periodicals; Neoplasms; Oncology; Tumors; Electronic journals; Periodicals; Case studies; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.994
• DOI: 10.1155/2018/5382852
• Languages: English
• ISSNs: 2090-6706

Abstract

Abstract : SOS is a rare complication of stem cell transplantation and has significant morbidity and mortality. We present three cases of SOS and highlight underlying risk factors for its development, such as impaired clearance of alkylating agents (especially melphalan) in patients with renal failure and prolonged infection. Although, melphalan and cyclophosphamide cause SOS less commonly than alkylating agents such as busulfan, physicians must use caution when administering these drugs to patients with underlying comorbidities such as renal failure that may increase the likelihood of development of SOS. This is due to unpredictable pharmacokinetics in patients with renal failure and therefore close drug monitoring is required. With the recent FDA approval of defibrotide in 2016, outcomes of SOS have improved and physician awareness is important for prompt diagnosis and treatment.