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

A Puente; J I Fortea; C Del Pozo; M Serrano; M Alonso-Peña; A Giráldez; L Tellez; J Martinez; M Magaz; L Ibañez; J Garcia; E Llop; C Alvarez-Navascues; M Romero; E Rodriguez; M T Arias Loste; A Antón; V Echavarria; C López; A Albillos; V Hernández-Gea; J C Garcia-Pagán; R Bañares; J Crespo; by REHEVASC group

doi:10.1016/j.dld.2024.04.010

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

Dig Liver Dis. 2024 May 7:S1590-8658(24)00711-4. doi: 10.1016/j.dld.2024.04.010. Online ahead of print.

Authors

A Puente¹, J I Fortea², C Del Pozo², M Serrano³, M Alonso-Peña², A Giráldez⁴, L Tellez⁵, J Martinez⁵, M Magaz⁶, L Ibañez⁷, J Garcia⁷, E Llop⁸, C Alvarez-Navascues⁹, M Romero¹⁰, E Rodriguez⁴, M T Arias Loste², A Antón², V Echavarria², C López¹¹, A Albillos⁵, V Hernández-Gea⁶, J C Garcia-Pagán⁶, R Bañares⁷, J Crespo²; by REHEVASC group

Affiliations

¹ Gastroenterology and Hepatology Department, Clinical and Traslational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital. Santander. Spain. Electronic address: angelam.puente@scsalud.es.
² Gastroenterology and Hepatology Department, Clinical and Traslational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital. Santander. Spain.
³ Department of Oncology. Marques de Valdecilla University Hospital. IDIVAL. Santander. Spain. Electronic address: marina.serrano92@gmail.com.
⁴ Digestive Diseases Research Unit, Virgen Del Rocío University Hospital.Liver Diseases, Instituto de Biomedicina de Sevilla, IbiS. Cell Biology Department, Faculty of Biology, University of Seville, Seville, Andalusia, Spain.
⁵ Department of Digestive Diseases. Hospital Ramón y Cajal. CIBEREHD. Madrid. Spain.
⁶ Barcelona Hepatic Hemodynamic Lab. Liver Unit. Hospital Clinic. IDIBAPS. University of Barcelona. Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver). CIBEREHD. Barcelona. Spain.
⁷ Department of Hepatology, Hospital Gregorio Marañon, Madrid, CIBEREHD, Spain.
⁸ Department of Digestive Diseases, Hospital Universitario Puerta de Hierro, Madrid, Spain.
⁹ Department of Digestive Diseases, Hospital Central de Asturias, Oviedo, Spain.
¹⁰ Department of Digestive Diseases, Complejo Hospitalario de Toledo, Toledo, Spain.
¹¹ Department of Oncology. Marques de Valdecilla University Hospital. IDIVAL. Santander. Spain.

PMID: 38719628
DOI: 10.1016/j.dld.2024.04.010

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.