Veno-Occlusive Disease of the Liver After Chemotherapy of Acute Leukemia

Griner, Paul F.

doi:10.7326/0003-4819-85-5-578

Cited by 121 publications

(33 citation statements)

References 18 publications

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“…30 Furthermore, several cases of veno-occlusive disease and hepatic nodular hyperplasia with portal hypertension have been reported in patients treated with TG combined with cytotoxic agents for leukaemia. [31][32][33] No such lesion was observed in our series. However, the TG dose was quite low (20 mg) compared to the one used for leukaemia, and the follow-up was still short.…”

Section: Discussionmentioning

confidence: 87%

Tioguanine in patients with Crohn's disease intolerant or resistant to azathioprine/mercaptopurine

Bonaz

Boitard

Marteau

et al. 2003

Aliment Pharmacol Ther

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Summary Background: Tioguanine (TG) is an antimetabolite which may be regarded as an alternative to azathioprine (AZA)/mercaptopurine (MP) in patients with inflammatory bowel diseases. Aims : To evaluate the tolerance and efficacy of TG in patients with Crohn's disease, intolerant or resistant to AZA/MP. Methods : An open prospective study was made on Crohn's disease patients treated with TG. Intolerance to AZA/MP was defined as a reaction occurring within 1 month after introduction of AZA/MP, including pancreatitis, abdominal pain, fever, arthralgia, myalgia, cutaneous rash, fatigue, alopecia, hepatitis and digestive intolerance. Resistance to AZA/MP was defined as the persistence of activity after at least 3 months of AZA/MP therapy. Results : Forty‐nine Crohn's disease patients (36 women, 13 men; intolerance: n = 39; resistance: n= 10) were treated with TG (20 mg/day). Clinical pancreatitis did not recur under TG. Five patients (10%) had to stop TG due to intolerant reactions observed 13–21 days after TG was started. No haematological side‐effects were observed under TG. The probability of clinical remission without corticosteroids or infliximab at 6 and 12 months was 46% and 79%, respectively, in the 40 patients with active disease at baseline. The probability of clinical relapse during maintenance TG therapy at 6 and 12 months was 29% and 53%, respectively, in the 28 patients in remission at baseline or who had achieved remission on TG. Conclusions : TG is a possible alternative treatment in Crohn's disease patients, intolerant (especially for pancreatitis) or resistant to AZA/MP.

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Section: Discussionmentioning

confidence: 87%

Tioguanine in patients with Crohn's disease intolerant or resistant to azathioprine/mercaptopurine

Bonaz

Boitard

Marteau

et al. 2003

Aliment Pharmacol Ther

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“…Few reports of TGassociated VOD were reported in the medical literature, and most episodes occurred with exposure to additional drugs. [36][37][38][39] One case of reversible VOD developed in a patient receiving TG alone for treatment of psoriasis, but at very high oral doses. 40 Although several patients on the CCG-1942 intravenous TG pilot developed reversible VOD while receiving daily oral TG, prior intravenous TG was presumed to be a predisposing factor.…”

Section: Discussionmentioning

confidence: 99%

Oral 6-mercaptopurine versus oral 6-thioguanine and veno-occlusive disease in children with standard-risk acute lymphoblastic leukemia: report of the Children's Oncology Group CCG-1952 clinical trial

Stork

Matloub

Broxson

et al. 2010

Blood

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“…6-thioguanine, another antipurine, has been implicated in the production of hepatic veno-occlusive disease (VOD) [63][64][65][66] and in a single case of peliosis hepatis [67]. An early report [68] described jaundice among the adverse reactions.…”

Section: Antimetabolitesmentioning

confidence: 99%

Hepatotoxicity of Chemotherapy

2001

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After assessment of tumor histology, the next important factor to consider in the selection of a chemotherapy regime is organ function. Patients who are to receive chemotherapy require careful assessment of liver function prior to treatment to determine which drugs may not be appropriate, and which drug doses should be modified. Following therapy abnormalities of liver function tests may be due to the therapy rather than to progressive disease, and this distinction is of critical importance. Furthermore, not all abnormalities in liver function are due to the tumor or its treatment, and other processes, such as hepatitis, must be kept in mind. This article reviews the hepatic toxicity of chemotherapeutic agents, and suggests dose modifications based upon liver function abnormalities. Emphasis is placed on agents known to be hepatotoxic, and those agents with hepatic metabolism.

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Veno-Occlusive Disease of the Liver After Chemotherapy of Acute Leukemia

Cited by 121 publications

References 18 publications

Tioguanine in patients with Crohn's disease intolerant or resistant to azathioprine/mercaptopurine

Tioguanine in patients with Crohn's disease intolerant or resistant to azathioprine/mercaptopurine

Oral 6-mercaptopurine versus oral 6-thioguanine and veno-occlusive disease in children with standard-risk acute lymphoblastic leukemia: report of the Children's Oncology Group CCG-1952 clinical trial

Hepatotoxicity of Chemotherapy

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