Impact of Oral Eicosapentaenoic Acid on Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome Onset Prevention: Single-Center Retrospective Analysis
Miyazaki Y, Narumi H, Azuma T, Tanimoto K, Masuda Y, Kato J, Konishi T, Nabe S, Maruta M, Ochi T, Yamanouchi J, Takenaka K (2025) · Transplantation and Cellular Therapy · n=138
Характеристика исследования
- Дизайн
- single-center retrospective analysis of 138 allogeneic HSCT in 123 patients (Ehime University Hospital, Japan, April 2008-June 2024)
- Размер выборки (n)
- 138
- Вмешательство
- Oral eicosapentaenoic acid (EPA) 1800 mg/d divided into 2-3 doses + ursodeoxycholic acid post allo-HSCT (n=91)
- Компаратор
- Ursodeoxycholic acid alone post allo-HSCT (n=47)
- Первичная конечная точка
- Incidence of VOD/SOS after allogeneic HSCT
- Основной результат
- VOD/SOS occurred in 0 of 91 EPA recipients (0%) vs 3 of 47 non-EPA recipients (6.5%, p=0.014); no difference in 100-day post-transplant mortality between groups
- Длительность наблюдения
- Up to 100 days post-HSCT
- PMID
- 41057124
Ключевые выводы
- 16-year single-center experience (138 transplants in 123 patients)
- 0% VOD/SOS in EPA group vs 6.5% in non-EPA group (p=0.014)
- EPA 1800 mg/d dose used in standard practice
- No difference in early post-transplant mortality
- Hypothesis-generating; warrants prospective trial
Ограничения
- Retrospective design with confounding by indication possible
- Single-center experience limits generalizability
- Small absolute event numbers (3 VOD/SOS cases)
- Era effects across 16 years
- Not applicable to whole-leech hirudotherapy
Клиническое значение
Miyazaki 2025 introduces oral EPA as a potentially low-cost, low-toxicity VOD/SOS prevention strategy worth further investigation. For ASH, this work illustrates how a nutritional supplement might serve as an alternative to pharmaceutical defibrotide, distinct from the K040187 device-leech US clinical practice but illustrative of broader principles of mechanistic prevention.
Связанные исследования
Defibrotide for prophylaxis of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) in pediatric high-risk patients: consensus guidelines from the European Society for Blood and Marrow Transplantation (EBMT)
Corbacioglu S, Bajwa R, Antmen AB, Balduzzi A, Boelens JJ, Bonifazi F, Cesaro S, Ciceri F, Colecchia A, Dignan F, Kleinschmidt K, Mahadeo KM, Pagliuca A, Sedlacek P, Shaw PJ, Stein J, Szmit Z, Tambaro F, Ince E, Verna M, Yesilipek A, Zecca M, Richardson PG, Mohty M, Kalwak K (2026)
Burden of illness of non-hematopoietic stem cell transplant-related hepatic sinusoidal obstruction syndrome: A systematic review
Fan L, Stewart F, Ruiz K, Devani D, Fusco N, Gill M, Amber V, Su W, Gangi A, Hanvesakul R (2024)
Hepatic Sinusoidal Obstruction Syndrome/Veno-Occlusive Disease (SOS/VOD) Primary Prophylaxis in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Network Meta-Analysis of Randomized Controlled Trials
Sousa-Pimenta M, Martins Â, Estevinho LM, Pinho Vaz C, Leite L, Mariz J (2024)