Cargando…

Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy

Inotuzumab ozogamicin (INO) showed improved treatment outcomes for relapsed or refractory B-cell precursor acute lymphoblastic leukemia (BCP-ALL) but can induce hepatotoxic adverse events. Hepatic venoocclusive disease/sinusoidal obstruction syndrome (VOD/SOS) frequently develops after allogeneic he...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Joonyeop, Yoon, Jae-Ho, Kwag, Daehun, Lee, Jong-Hyuk, Kim, Tong Yoon, Min, Gi June, Park, Sung-Soo, Park, Silvia, Lee, Sung-Eun, Cho, Byung-Sik, Eom, Ki-Seong, Kim, Yoo-Jin, Kim, Hee-Je, Min, Chang-Ki, Cho, Seok-Goo, Wook Lee, Jong, Hak Lee, Sung, Lee, Seok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8721405/
https://www.ncbi.nlm.nih.gov/pubmed/34987745
http://dx.doi.org/10.1177/20406207211066176
_version_ 1784625334750019584
author Lee, Joonyeop
Yoon, Jae-Ho
Kwag, Daehun
Lee, Jong-Hyuk
Kim, Tong Yoon
Min, Gi June
Park, Sung-Soo
Park, Silvia
Lee, Sung-Eun
Cho, Byung-Sik
Eom, Ki-Seong
Kim, Yoo-Jin
Kim, Hee-Je
Min, Chang-Ki
Cho, Seok-Goo
Wook Lee, Jong
Hak Lee, Sung
Lee, Seok
author_facet Lee, Joonyeop
Yoon, Jae-Ho
Kwag, Daehun
Lee, Jong-Hyuk
Kim, Tong Yoon
Min, Gi June
Park, Sung-Soo
Park, Silvia
Lee, Sung-Eun
Cho, Byung-Sik
Eom, Ki-Seong
Kim, Yoo-Jin
Kim, Hee-Je
Min, Chang-Ki
Cho, Seok-Goo
Wook Lee, Jong
Hak Lee, Sung
Lee, Seok
author_sort Lee, Joonyeop
collection PubMed
description Inotuzumab ozogamicin (INO) showed improved treatment outcomes for relapsed or refractory B-cell precursor acute lymphoblastic leukemia (BCP-ALL) but can induce hepatotoxic adverse events. Hepatic venoocclusive disease/sinusoidal obstruction syndrome (VOD/SOS) frequently develops after allogeneic hematopoietic cell transplantation (allo-HCT), and INO is a strong pretransplant risk factor. However, VOD/SOS can occur just after INO therapy. Here, we describe a BCP-ALL patient treated with INO for isolated extramedullary relapse after allo-HCT. The patient experienced elevated liver enzymes with ascites at 21 days from the last INO dose. Although she met the criteria for VOD/SOS, the diagnosis was challenging because of her ongoing hepatic graft-versus-host disease (GVHD) and normal portal vein flow on Doppler sonogram. The radiologist suggested liver cirrhosis based on computed tomography, with VOD/SOS, liver cirrhosis, and GVHD assumed to be differential diagnoses. She received supportive care with GVHD management; however, due to progressive hepatic failure, we conducted emergent deceased-donor liver transplantation, and the pathologic findings indicated VOD/SOS. Her leukemia was stable, but she died of sepsis after 3 months. INO use is a high-risk factor for VOD/SOS, but an accurate diagnosis can be challenging due to various hepatic complications. Early diagnosis and proper management for VOD/SOS is important for improved outcomes.
format Online
Article
Text
id pubmed-8721405
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-87214052022-01-04 Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy Lee, Joonyeop Yoon, Jae-Ho Kwag, Daehun Lee, Jong-Hyuk Kim, Tong Yoon Min, Gi June Park, Sung-Soo Park, Silvia Lee, Sung-Eun Cho, Byung-Sik Eom, Ki-Seong Kim, Yoo-Jin Kim, Hee-Je Min, Chang-Ki Cho, Seok-Goo Wook Lee, Jong Hak Lee, Sung Lee, Seok Ther Adv Hematol Case Report Inotuzumab ozogamicin (INO) showed improved treatment outcomes for relapsed or refractory B-cell precursor acute lymphoblastic leukemia (BCP-ALL) but can induce hepatotoxic adverse events. Hepatic venoocclusive disease/sinusoidal obstruction syndrome (VOD/SOS) frequently develops after allogeneic hematopoietic cell transplantation (allo-HCT), and INO is a strong pretransplant risk factor. However, VOD/SOS can occur just after INO therapy. Here, we describe a BCP-ALL patient treated with INO for isolated extramedullary relapse after allo-HCT. The patient experienced elevated liver enzymes with ascites at 21 days from the last INO dose. Although she met the criteria for VOD/SOS, the diagnosis was challenging because of her ongoing hepatic graft-versus-host disease (GVHD) and normal portal vein flow on Doppler sonogram. The radiologist suggested liver cirrhosis based on computed tomography, with VOD/SOS, liver cirrhosis, and GVHD assumed to be differential diagnoses. She received supportive care with GVHD management; however, due to progressive hepatic failure, we conducted emergent deceased-donor liver transplantation, and the pathologic findings indicated VOD/SOS. Her leukemia was stable, but she died of sepsis after 3 months. INO use is a high-risk factor for VOD/SOS, but an accurate diagnosis can be challenging due to various hepatic complications. Early diagnosis and proper management for VOD/SOS is important for improved outcomes. SAGE Publications 2021-12-21 /pmc/articles/PMC8721405/ /pubmed/34987745 http://dx.doi.org/10.1177/20406207211066176 Text en © The Author(s), 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Lee, Joonyeop
Yoon, Jae-Ho
Kwag, Daehun
Lee, Jong-Hyuk
Kim, Tong Yoon
Min, Gi June
Park, Sung-Soo
Park, Silvia
Lee, Sung-Eun
Cho, Byung-Sik
Eom, Ki-Seong
Kim, Yoo-Jin
Kim, Hee-Je
Min, Chang-Ki
Cho, Seok-Goo
Wook Lee, Jong
Hak Lee, Sung
Lee, Seok
Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy
title Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy
title_full Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy
title_fullStr Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy
title_full_unstemmed Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy
title_short Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy
title_sort hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic gvhd following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8721405/
https://www.ncbi.nlm.nih.gov/pubmed/34987745
http://dx.doi.org/10.1177/20406207211066176
work_keys_str_mv AT leejoonyeop hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT yoonjaeho hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT kwagdaehun hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT leejonghyuk hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT kimtongyoon hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT mingijune hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT parksungsoo hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT parksilvia hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT leesungeun hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT chobyungsik hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT eomkiseong hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT kimyoojin hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT kimheeje hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT minchangki hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT choseokgoo hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT wookleejong hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT hakleesung hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy
AT leeseok hepaticvenoocclusivediseasesinusoidalobstructionsyndromewithnormalportalveinflowmimickingaggravatedchronichepaticgvhdfollowinginotuzumabozogamicinsalvagetherapyacasereportofpathologicradiologicdiscrepancy