Veno-Occlusive Disease of the Liver Associated With Thiopurines in a Child With Acute Lymphoblastic Leukemia

Merino, José; Casanova, Francesco; Sáez-Royuela, F; Velasco, Aritza Brizuela; González, José

doi:10.1080/08880010050034391

Cited by 9 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In regard to the included case reports, the 6TG dosage was higher in the ones that reported hepatotoxicity (14–125 mg/m 2 /day) [48–54,56,58–60,63] compared to the ones that did not report hepatotoxicity (0.8–21 mg/m 2 /day). [42,55,57,62]…”

Section: Resultsmentioning

confidence: 99%

Hepatotoxicity during 6-thioguanine treatment in inflammatory bowel disease and childhood acute lymphoblastic leukaemia: A systematic review

et al. 2019

View full text Add to dashboard Cite

Background The recently established association between higher levels of DNA-incorporated thioguanine nucleotides and lower relapse risk in childhood acute lymphoblastic leukaemia (ALL) calls for reassessment of prolonged 6-thioguanine (6TG) treatment, while avoiding the risk of hepatotoxicity. Objectives To assess the incidence of hepatotoxicity in patients treated with 6TG, and to explore if a safe dose of continuous 6TG can be established. Data sources Databases, conference proceedings, and reference lists of included studies were systematically searched for 6TG and synonyms from 1998–2018. Methods We included studies of patients with ALL or inflammatory bowel disorder (IBD) treated with 6TG, excluding studies with 6TG as part of an intensive chemotherapy regimen. We uploaded a protocol to PROSPERO (registration number CRD42018089424). Database and manual searches yielded 1823 unique records. Of these, 395 full-texts were screened for eligibility. Finally, 134 reports representing 42 studies were included. Results and conclusions We included data from 42 studies of ALL and IBD patients; four randomised controlled trials (RCTs) including 3,993 patients, 20 observational studies including 796 patients, and 18 case reports including 60 patients. Hepatotoxicity in the form of sinusoidal obstruction syndrome (SOS) occurred in 9–25% of the ALL patients in two of the four included RCTs using 6TG doses of 40–60 mg/m 2 /day, and long-term hepatotoxicity in the form of nodular regenerative hyperplasia (NRH) was reported in 2.5%. In IBD patients treated with 6TG doses of approximately 23 mg/m 2 /day, NRH occurred in 14% of patients. At a 6TG dose of approximately 12 mg/m 2 /day, NRH was reported in 6% of IBD patients, which is similar to the background incidence. According to this review, doses at or below 12 mg/m 2 /day are rarely associated with notable hepatotoxicity and can probably be considered safe.

show abstract

Section: Resultsmentioning

confidence: 99%

Hepatotoxicity during 6-thioguanine treatment in inflammatory bowel disease and childhood acute lymphoblastic leukaemia: A systematic review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Hepatic VOD results from obliteration of the small intrahepatic venules that damages the hepatocytes of the central zone and the surrounding sinusoids [5][6][7]. Such damage has been described following exposure to pyrrolizidine alkaloids in contaminated cereals or herbal teas and after hepatic irradiation and cytoreductive chemotherapy with single or multiple agents [3,[8][9][10][11][12]. Nowadays it is most commonly seen after bone marrow transplantation [6,11].…”

Section: Discussionmentioning

confidence: 99%

“…Such damage has been described following exposure to pyrrolizidine alkaloids in contaminated cereals or herbal teas and after hepatic irradiation and cytoreductive chemotherapy with single or multiple agents [3,[8][9][10][11][12]. Nowadays it is most commonly seen after bone marrow transplantation [6,11].…”

Section: Discussionmentioning

confidence: 99%

Veno‐occlusive disease of the liver associated with chronic myelomonocytic leukemia treated with vincristine and standard doses of cytarabine

et al. 2005

View full text Add to dashboard Cite

A unique case of a 72-year-old man with chronic myelomonocytic leukemia (CMML) who developed hepatic veno-occlusive disease (VOD) after treatment with a single dose of vincristine and standard doses of cytarabine is described. Unexpected peroneal nerve palsy suggestive of vincristine neurotoxicity occurred concurrently and pointed to vincristine as the most likely cause of the VOD. To the best of our knowledge, association between vincristine and hepatic VOD has not been previously described in chemotherapy-naive patients with CMML. Am.

show abstract

“…VOD generally occurs as a complication of bone marrow transplantation 1–3 and chemotherapy in Wilms tumor 4–8. Development of fatal VOD after standard doses of chemotherapy in malignancies except Wilms tumor is rare and only a few cases have been reported in children, the majority being acute lymphoblastic leukemia 9–11 and rhabdomyosarcoma 12–14. Conventional chemotherapy related VOD shows a spontaneous recovery in most cases 15.…”

Section: Introductionmentioning

confidence: 99%

Veno‐occlusive disease of the liver in a child after chemotherapy for brain tumor

Elli

Pınarlı

Dağdemir

et al. 2005

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Veno-occlusive disease (VOD) of the liver is a life-threatening state generally occurring as a complication of bone marrow transplantation or chemotherapy for Wilms' tumor. Veno-occlusive disease after standard dose chemotherapy in malignancies other than Wilms' tumor is rare and only a few cases have been published in children. We report a 19 month-old-girl with medulloblastoma who experienced fatal VOD of liver after only one course of chemotherapy including carboplatin, vincristine and CCNU for medulloblastoma. As our knowledge, this is the first report of VOD after standard dose chemotherapy for brain tumor in childhood.

show abstract

Veno-Occlusive Disease of the Liver Associated With Thiopurines in a Child With Acute Lymphoblastic Leukemia

Cited by 9 publications

References 5 publications

Hepatotoxicity during 6-thioguanine treatment in inflammatory bowel disease and childhood acute lymphoblastic leukaemia: A systematic review

Hepatotoxicity during 6-thioguanine treatment in inflammatory bowel disease and childhood acute lymphoblastic leukaemia: A systematic review

Veno‐occlusive disease of the liver associated with chronic myelomonocytic leukemia treated with vincristine and standard doses of cytarabine

Veno‐occlusive disease of the liver in a child after chemotherapy for brain tumor

Contact Info

Product

Resources

About