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Analysis reveals syndecan-1 is linked to severe sinusoidal obstruction syndrome and acute graft-versus-host disease in children post-HSCT, suggesting potential therapies.
Endothelial damage may play a key role in several non‐infectious toxicities following hematopoietic stem cell transplantation (HSCT). We explored damage to the endothelial glycocalyx in 113 children undergoing HSCT by measuring syndecan‐1 plasma levels. Syndecan‐1 levels were elevated in patients with severe sinusoidal obstruction syndrome (SOS) and steroid‐refractory/dependent acute graft‐versus‐host disease, but remained low in milder cases. In patients with SOS, high syndecan‐1 levels were associated with prolonged diuretic treatment and thrombocytopenia. These findings provide new insights into the pathophysiology of endothelial‐related toxicities after HSCT and may lead to the development of more individualized and targeted therapeutic approaches.
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Horan et al. (2025) studied this question.
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