Opinion
Video
VOD Overview
Author(s):
Mitchell Cairo, MD, and Sergio Giralt, MD, offer an overview of veno-occlusive disease, an endothelial damage syndrome, and its prognosis.
This is a synopsis of an Insights series featuring Mitchell S. Cairo, MD, of New York Medical College, and Sergio Giralt, MD, of Memorial Sloan Kettering Cancer Center.
Dr. Sergio Giralt, Professor of Medicine at Weill Cornell Medical College, Deputy Division Head of Hematologic Malignancies at Memorial Sloan Kettering Cancer Center, and attending physician in the Adult BMT Service at Memorial Sloan Kettering Cancer Center, welcomed Dr. Mitch Cairo, Cancer Center Director and Transplant Director at Westchester Medical Center and Professor of Pediatrics, Medicine and other departments at New York Medical College, to discuss treatment options for patients with veno-occlusive disease (VOD) and how to best manage these patients. They also discussed the latest in clinical research and the impact on future treatment options.
Dr. Giralt provided an overview of VOD, also known as hepatic sinusoidal obstruction syndrome (SOS), including its pathophysiology and primary patient population affected. He noted VOD was described over 100 years ago as a cirrhosis of the liver occurring in patients in South Africa after ingesting wild berries called Senecio. The first description in the transplant setting was by Hillard Lazarus after mitomycin C therapy. VOD has various reported incidences between 13-17%, recently 2-3%. Dr. Giralt stated VOD is part of a spectrum of endothelial damage syndromes including VOD, idiopathic pneumonia syndrome, fluid overload, capillary leak syndrome, and thrombotic microangiopathy. Patients are predisposed to chemotherapy-induced endothelial damage. Once the hepatic endothelium is damaged, it causes prothrombotic events within the capillaries, eventually causing small clots, portal hypertension, flow reversal, and disruption of liver function. For colleagues, VOD is an endothelial damage syndrome after high-dose chemotherapy in predisposed patients, ranging from mild to severe. Severe VOD with multiorgan failure can rapidly lead to death if not treated appropriately.
*Video synopsis is AI-generated and reviewed by OncLive editorial staff.
