6-Thioguanine-Induced Hepatic Sinusoidal Obstruction Syndrome in a Leukemic Child with TPMT Heterozygote
- Author:
Young Joo KWON
1
;
Jong Hyung YOON
;
Jeong A PARK
;
Ji Seok BANG
;
Byung Kiu PARK
;
Joon Il CHOI
;
Sun Young KONG
;
Hyeon Jin PARK
Author Information
1. Center for Pediatric Oncology, National Cancer Center, Goyang, Korea. hjpark@ncc.re.kr
- Publication Type:Case Report
- Keywords:
Hepatic sinusoidal obstruction syndrome;
Thiopurine methyltransferase;
6-Thioguanine;
Polymorphism
- MeSH:
6-Mercaptopurine;
Acetylcysteine;
Child;
Cyclophosphamide;
Cytarabine;
Glutathione;
Hematopoietic Stem Cell Transplantation;
Hepatic Veno-Occlusive Disease;
Heterozygote;
Humans;
Methotrexate;
Methyltransferases;
Polydeoxyribonucleotides;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
Thioguanine
- From:Clinical Pediatric Hematology-Oncology
2012;19(2):109-113
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hepatic sinusoidal obstruction syndrome (hSOS) can be developed as a common complication after hematopoietic stem cell transplantation (HSCT), and rarely after 6-thioguanine-based chemotherapy without HSCT. A four-year-old boy with heterozygotic polymorphism for thiopurine methyltransferase (TPMT) developed hSOS after he received chemotherapy with cytarabine, cyclophosphamide, intrathecal methotrexate and 6-thioguanine (6-TG) as reconsolidation chemotherapy of acute lymphoblastic leukemia (ALL). He was treated with defibrotide, N-acetylcysteine, urusodeoxycholic acid, glutathione, and supportive care. He recovered completely in nine days without long-term complication, and completed chemotherapy with 6-mercaptopurine without severe complication. We report a case of hSOS developed in an ALL patient with TPMT heterozygote after 6-TG based reconsolidation chemotherapy.
