Clinical and genetic factors involved in Porto-sinusoidal vascular disorder after oxaliplatin exposure

Dig Liver Dis. 2024 Oct;56(10):1721-1729. doi: 10.1016/j.dld.2024.04.010. Epub 2024 May 7.

Abstract

Background and aims: Oxaliplatin (OX) has been described as a potential etiologic agent for porto-sinusoidal vascular disorder (PSVD). Our aim was to describe the natural history of PSVD due to OX in colon cancer (CRC) and identify risk factors for its development.

Methods: We made a multicenter retrospective case-control (ratio 1:3) study with patients diagnosed of PSVD-OX. Baseline data, end of treatment, years of follow-up and diagnosis of PSVD were collected and compared to controls (without PSVD). Besides, 16 different SNPs were selected from bibliography and analyzed by genotyping in the case group to identify potential genetic risk factors.

Results: 41 cases were identified, with a median time to PSVD diagnosis after the end of OX of 34 months. Spleen diameter was the strongest predictor of PSVD during treatment (OR 43.94 (14.48-133.336); p < 0.0001). Additionally, thrombocytopenia (<150 × 10^9) at one year was a significant disease risk marker (OR 9.35; 95% CI: 3.71-23.58; p = 0.001). We could not establish any significant association between the selected SNPs and PSVD diagnosis.

Conclusion: The increase of spleen diameter is the strongest predictor of PSVD in patients treated with OX for CRC. These patients could be candidates for a specific follow-up of portal hypertension-related complications.

Keywords: Idiopathic portal hypertension; Oxaliplatin; Portal hypertension; Porto-sinusoidal vascular disorder.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Agents* / therapeutic use
  • Case-Control Studies
  • Colonic Neoplasms* / drug therapy
  • Colonic Neoplasms* / genetics
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Organoplatinum Compounds / adverse effects
  • Organoplatinum Compounds / therapeutic use
  • Oxaliplatin* / adverse effects
  • Polymorphism, Single Nucleotide
  • Retrospective Studies
  • Risk Factors
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / genetics

Substances

  • Oxaliplatin
  • Antineoplastic Agents
  • Organoplatinum Compounds