Sinusoidal Obstruction Syndrome (SOS) in Multiple Myeloma with Renal Failure

Table 2

Well-known risk factors for SOS (adapted from [1, 3]).

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Transplant-related factors

Unrelated donor

HLA-mismatched donor

Non-T-cell-depleted transplant

Myeloablative-conditioning regimen

Oral or high-dose busulfan-based regimen

High-dose total body irradiation-based regimen

Second HSCT

GVHD prophylaxis regimen

Patient and disease-related factors

Older age

Karnofsky score below 90%

Metabolic syndrome

Female receiving norethisterone

Advanced disease (beyond second CR or relapse/refractory)

Thalassemia

Genetic factors (GSTM1 polymorphism, C282Y allele, MTHFR 677CC/1298CC haplotype)

Infection/antibiotic/antiviral use (vancomycin, acyclovir)

Renal dysfunction due to impaired drug clearance

Hepatic related

Elevated liver function tests

Cirrhosis

Active viral hepatitis

Abdominal or hepatic irradiation

Previous use of gemtuzumab ozogamicin or inotuzumab ozogamicin

Hepatotoxic drugs

Iron overload

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