[Sinusoidal obstruction syndrome after BeAM conditioning regiment for autologous stem cell transplantation: Imputability of bendamustine? Report of two cases and literature review]

Rev Med Interne. 2018 Nov;39(11):882-885. doi: 10.1016/j.revmed.2018.03.009. Epub 2018 Apr 16.
[Article in French]

Abstract

Introduction: Sinusoidal obstruction syndrome is a rare complication of autologous hematopoietic stem cell transplantation. This syndrome is mainly described following conditioning regiment with busulfan, cyclophosphamide and/or total body irradiation.

Case reports: We report for the first time two cases of sinusoidal obstruction syndrome occurring lately after BeAM conditioning regiment (bendamustine, etoposide, aracytine, melphalan) for autologous stem cell transplantation in patients treated for malignant lymphoma.

Conclusion: Our observations highlight the difficulty to diagnose this complication with often non-specific clinical presentation and possible delayed occurrence after to transplantation, but also the therapeutic challenges, defibrotide being the only agent currently efficient. Physiopathology and potential responsibility of bendamustine in the sinusoidal obstruction syndrome occurrence will be discussed.

Keywords: Bendamustine; Greffe de cellules souches hématopoïétiques; Hematopoietic stem cell transplantation; Sinusoidal obstruction syndrome; Syndrome d’obstruction sinusoïdal.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bendamustine Hydrochloride / administration & dosage
  • Bendamustine Hydrochloride / adverse effects*
  • Carmustine / adverse effects
  • Carmustine / therapeutic use
  • Cytarabine / adverse effects
  • Cytarabine / therapeutic use
  • Etoposide / adverse effects
  • Etoposide / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hepatic Veno-Occlusive Disease / chemically induced*
  • Hepatic Veno-Occlusive Disease / pathology
  • Humans
  • Melphalan / adverse effects
  • Melphalan / therapeutic use
  • Middle Aged
  • Transplantation Conditioning / adverse effects*
  • Transplantation Conditioning / methods
  • Transplantation, Autologous

Substances

  • Cytarabine
  • Etoposide
  • Bendamustine Hydrochloride
  • Melphalan
  • Carmustine

Supplementary concepts

  • BEAM regimen