Sinusoidal obstruction syndrome during induction therapy for acute lymphoblastic leukemia managed with N‐acetyl Cysteine

Sahoo, Ranjit Kumar; Sharma, Atul

doi:10.1002/pbc.23142

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…However, hepatic VOD/SOS occurred at a surprisingly low frequency with 5 (3.1%) cases among the 160 patients enrolled. Later, two case reports, a 1‐year‐old female with Wilms tumor and an 18‐year‐old female with acute lymphoblastic leukemia who developed very severe VOD/SOS, showed rapid recovery after a more intense but 3‐day regimen of NAC infusion. These and other studies have confirmed that the use of NAC is safe in children.…”

Section: Discussionmentioning

confidence: 99%

Treatment of hepatic veno‐occlusive disease in children with N‐acetylcysteine

Lee

Aung

2018

Pediatric Blood & Cancer

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In our institution, hepatic veno‐occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) has been treated with N‐acetylcysteine (NAC) since 2008—a loading dose of 150 mg/kg, followed by 12 doses of 70 mg/kg 6 hourly. Nine children were diagnosed with hepatic VOD/SOS. Hepatic VOD/SOS occurred in seven children after stem cell transplantation and two were receiving chemotherapy for Wilms tumor. Their clinical severity was classified as moderate in two and severe in seven by the European Society for Blood and Marrow Transplantation criteria. All children recovered and were discharged from 4 to 16 days after diagnosis. No side effects were observed. Intravenous NAC is an effective treatment for hepatic VOD/SOS.

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Section: Discussionmentioning

confidence: 99%

Treatment of hepatic veno‐occlusive disease in children with N‐acetylcysteine

Lee

Aung

2018

Pediatric Blood & Cancer

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A stitch in time saves nine: timely use of N-acetyl cysteine (NAC) for chemotherapy-induced veno-occlusive disease (VOD)—is it a cost-effective alternative?

Tandra

Rupakumar

Vijayasekharan

et al. 2022

Support Care Cancer

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Hepatic Sinusoidal Obstruction Syndrome During Chemotherapy for Childhood Medulloblastoma

Kotecha

Buckland

Phillips

et al. 2014

Journal of Pediatric Hematology/Oncology

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Hepatic sinusoidal obstruction syndrome (HSOS), also known as veno-occlusive disease, is a well-recognized toxic complication after autologous and allogeneic hematopoietic stem cell transplant, during treatment of Wilms tumor and rhabdomyosarcoma associated with actinomycin-D, and during acute lymphoblastic leukemia therapy due to oral 6-thioguanine. However, its occurrence in the context of chemotherapy regimens for other childhood malignancies is rare. We report a 5-year-old girl with high-risk anaplastic medulloblastoma, who developed severe HSOS during her second cycle of maintenance chemotherapy, consisting of vincristine, cisplatin, and cyclophosphamide. She was treated with defibrotide with complete resolution of the HSOS. These findings and a review of the literature, highlight the occurrence of HSOS in children outside the established settings of hematopoietic stem cell transplantation, Wilms tumor, rhabdomyosarcoma, and acute lymphoblastic leukemia.

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Sinusoidal obstruction syndrome during induction therapy for acute lymphoblastic leukemia managed with N‐acetyl Cysteine

Cited by 3 publications

References 8 publications

Treatment of hepatic veno‐occlusive disease in children with N‐acetylcysteine

Treatment of hepatic veno‐occlusive disease in children with N‐acetylcysteine

A stitch in time saves nine: timely use of N-acetyl cysteine (NAC) for chemotherapy-induced veno-occlusive disease (VOD)—is it a cost-effective alternative?

Hepatic Sinusoidal Obstruction Syndrome During Chemotherapy for Childhood Medulloblastoma

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