Clinical hepatic indices serve as predictive markers for sinusoidal obstruction syndrome after allogeneic HSCT

Prediction and early diagnosis are critical for the effective treatment of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) after hematopoietic stem cell transplantation (HSCT). This study aimed to investigate the utility of clinical hepatic indices easily calculated in routine practice, namely the Endothelial Activation and Stress Index (EASIX), aspartate aminotransferase-to-platelet ratio index (APRI), Fibrosis-4 (FIB-4), reversed Albumin-Bilirubin grade (rALBI), Model for End-Stage Liver Disease (MELD), and MELD score and the serum sodium concentration (MELDNa). We retrospectively analyzed longitudinal clinical data from 175 allogeneic HSCTs at our institution. The 22 patients who eventually developed clinical SOS/VOD were used as the reference standard. At baseline, EASIX, APRI, FIB-4, rALBI, MELD, and MELDNa were analyzed using the receiver operating characteristic method, with resulting area under the curve (95% confidence interval) of 0.739 (0.607-0.871), 0.770 (0.641-0.898), 0.760 (0.645-0.875), 0.672 (0.530-0.815), 0.577 (0.440-0.713), and 0.642 (0.449-0.784), respectively. After HSCT, these indices were also associated with SOS/VOD, even 7 days before diagnosis (all p-values < 0.001). In conclusion, clinical hepatic indices are useful for prediction and early diagnosis of SOS/VOD in allogeneic HSCT recipients. Further studies are required to determine their optimal clinical application.