Esophageal Strictures During Treatment for Acute Lymphoblastic Leukemia

Abstract

Esophageal stricture is a rare complication of paediatric cancer treatment that usually occurs after esophageal exposure to radiotherapy. We describe 4 cases of esophageal stricture during chemotherapy for acute lymphoblastic leukemia. All patients presented with refractory vomiting and were diagnosed with radiologic contrast studies. None of the patients had received radiotherapy. Esophageal candidiasis was seen in 2 patients but the remaining 2 patients had earlier systemic candidiasis. High-dose dexamethasone may predispose these children to both esophageal candidiasis and peptic esophagitis. The etiology of esophageal strictures during treatment for acute leukemia is likely to be multifactorial but systemic candidiasis may play a significant role.

A Unique Case of a Patient with Rectal Cancer Who Developed Benign Esophageal Stenosis after Localized Rectal Radiation and Systemic Chemotherapy

“…Injury to the esophagus results in severe fibrosis, mucosal atrophy, ischemic ulcerations and esophageal strictures [10, 11]. Isolated chemotherapy-induced esophageal strictures are a very rare entity and have only been described in the pediatric literature, specifically in the management of acute leukemias.…”

Reflux esophageal stricture—a review of 30 years' experience in children

“…Strictures of the esophagus in children may result from caustic injury, congenital anomaly, chemoradiotherapy, inflammation, and chronic gastroesophageal reflux disease (GERD) [1][2][3][4]. Esophageal stricture occurring after prolonged GERD, known as peptic stricture (PS), can be identified in up to 15% of children with GERD and is a cause of immediate and long-term morbidity [5].…”

Esophageal Stricture Resulting from Systemic Chemotherapy for Solid Malignancy

“…Of the several thousand cases, included in these studies, only 2 cases of esophageal stricture were found in patients receiving chemotherapy alone. 4 , 5 In the adult population, only 2 patients have been previously identified who developed stricture during treatment with systemic chemotherapy. 2 , 3 In both of these cases, symptoms began within 3 weeks of initiation of systemic chemotherapy, as in our case.…”

“…2 , 3 In pediatric patients, it has been identified as a rare complication following induction therapy for acute leukemia. 4 …”