Treatment-related sinusoidal obstruction syndrome in children with de novo acute lymphoblastic leukemia during intensification

Abstract

SOS following short courses of 6-TG in DI is clinically distinct from SOS following prolonged courses of 6-TG in maintenance, particularly in its early presentation and outcomes.

Defibrotide for the treatment of hepatic veno‐occlusive disease/sinusoidal obstruction syndrome following nontransplant‐associated chemotherapy: Final results from a post hoc analysis of data from an expanded‐access program

“…Clinical and laboratory remission were obtained in all six patients. In another study of treatment of acute lymphoblastic leukemia with a brief course of 6thioguanine, 35 The AE profile observed in the present cohort was consistent with that seen in the VOD/SOS population in the post-HSCT setting, and with the known safety profile of defibrotide in such patients. 20,23,25 In the T-IND overall, defibrotide tolerability was better than in other VOD/SOS patient populations, 24,25 prophylaxis study, 26 hemorrhage was the most commonly reported treatment-related AE; however, cumulative hemorrhage incidence was the same between the defibrotide group (22%) and the control group (21%).…”

“…Clinical and laboratory remission were obtained in all six patients. In another study of treatment of acute lymphoblastic leukemia with a brief course of 6‐thioguanine, 10/680 (1.5%) children developed VOD/SOS; none of the patients were treated with defibrotide. Eight patients with moderate disease made a full recovery; two patients with severe disease died during hospitalization.…”

Sinusoidal obstruction syndrome in a paediatric patient with acute lymphoblastic leukaemia after completion of reinduction therapy according to ALL Intercontinental Berlin-Frankfurt-Münster 2009

“…In children with haematopoietic malignancies, receiving conventional chemotherapy, SOS was most often observed as the complication of oral 6-thioguanine (6-TG) during maintenance therapy in ALL. SOS following short (14-days) courses of thioguanine is an extremely rare, clinically different, and poorly understood syndrome [7]. Here, we report an uncommon case of sinusoidal obstruction syndrome in a paediatric patient with ALL shortly after completing block of reinduction therapy according to the ALL Intercontinental Berlin-Frankfurt-Münster 2009 (ALL IC BFM 2009) treatment protocol.…”

Considerations on the Hematologic Toxicity of the all IC-BFM 2002/2009 Therapeutic Protocol in Children with Acute Lymphoblastic Leukemia

“…They will require blood product transfusions which, at their turn, will generate other possible complications (allergic reactions, infections) [11][12][13][14].…”

“…Medullary aplasia represents the most dangerous picture which may occur after chemotherapy and its seriousness is given by the possibility for an infectious clinical picture to occur, which may lead to septicemia, to a hemorrhagic syndrome or to mucosal lesions associated with hemorrhage and necrosis [7][8][9][10][11][12][13][14][15][16][17][18][19].…”