Opinion
Video
VOD Risk Factors
Author(s):
Experts discuss the risk factors associated with VOD and which high-risk patients should be monitored for signs and symptoms of this disease.
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. Giralt discussed risk factors and current incidence of VOD in 2024 among post-hematopoietic cell transplant (HCT) patients. He noted reported VOD incidence ranges from 2% to 14%, with the highest risk groups being pediatric patients receiving autologous transplant for neuroblastoma with high-dose or triple alkylator therapy, and those with osteosarcoma. More common predisposition factors are previous exposure to gemtuzumab ozogamicin or obinutuzumab, heavy pretreatment such as a second autologous or allogeneic transplant, previous autologous transplant, preexisting liver disease or high ferritin levels from transfusions, and high-dose busulfan and cyclophosphamide or total body irradiation conditioning regimens. Specific associations exist between VOD and busulfan-based therapies and tacrolimus-based graft-versus-host disease prophylaxis. In summary, those at highest risk for VOD are patients with preexisting liver damage, those receiving intense conditioning regimens, and patients at particularly high baseline risk including those with neuroblastoma getting tandem transplants or osteosarcoma.
*Video synopsis is AI-generated and reviewed by OncLive editorial staff.
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