Prophylactic, preemptive, and curative treatment for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a position statement from an international expert group
Bibliographic record
Abstract
Sinusoidal obstruction syndrome (SOS), formerly called veno-occlusive disease (VOD; referred to as SOS/VOD hereafter), is a life-threatening complication that can occur after hematopoietic stem cell transplantation (HCT) [ 1 ]. The conditioning regimen and immune-mediated injury following allogeneic HCT (allo-HCT) generate toxic metabolites that damage sinusoidal endothelial cells. The expression of tissue and von Willebrand factors contribute to the clothing cascade activation, perpetuate the endothelial cell injury leading to the formation of gaps in the hepatic sinusoidal endothelium [ 2 ]. Red blood cells penetrate through those gaps in the perisinusoidal space, beneath the endothelial cells, and subsequently dissect off the endothelial lining, all of which embolize as part of the sinusoid flow and in turn obstruct the sinusoid [ 1 ]. This process reduce hepatic outflow, produces postsinusoidal hypertension with tissue ischemia in zone 3 of the acinus, and concomitant hepatocellular damage; all of which results in the clinical symptoms of SOS/VOD and an associated hepato-renal syndrome, namely fluid retention, ascites, weight gain, painful hepatomegaly, and jaundice [ 3 , 4 , 5 ]. In the most severe cases, patients may develop multiorgan dysfunction (MOD) with pulmonary and renal involvement, encephalopathy and, ultimately, death. Despite the incidence of SOS/VOD being limited, around 10–15% after myeloablative allo-HCT and up to 5% after reduced-intensity conditioning (RIC) allo-HCT, particular attention must be paid to permit its early detection and treatment and to prevent the development of the most severe forms, which are in turn associated with a very high mortality rate (>80%) [ 1 , 5 ]. In an effort to improve early diagnosis, the European Group for Blood and Marrow Transplantation (EBMT) revise the modified Seattle [ 6 ] and Baltimore [ 4 ] criteria, and recently published revised diagnosis and severity criteria for adults [ 7 ].
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.005 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".