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KMID : 0387820120190020109
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Clinical Pediatric Hematology-Oncology
2012 Volume.19 No. 2 p.109 ~ p.113
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6-Thioguanine-Induced Hepatic Sinusoidal Obstruction Syndrome in a Leukemic Child with TPMT Heterozygote
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Kwon Young-Joo
Yoon Jong-Hyung
Park Byung-Kiu
Park Hyeon-Jin
Park Jeong-A
Bang Ji-Seok
Choi Joon-Il
Kong Sun-Young
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Abstract
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Hepatic sinusoidal obstruction syndrome (hSOS) can be developed as a common compli-cation after hematopoietic stem cell transplantation (HSCT), and rarely after 6-thio-guanine-based chemotherapy without HSCT. A four-year-old boy with heterozygotic polymorphism for thiopurine methyltransferase (TPMT) developed hSOS after he re-ceived 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, gluta-thione, 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 hetero-zygote after 6-TG based reconsolidation chemotherapy.
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KEYWORD
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Hepatic sinusoidal obstruction syndrome, Thiopurine methyltransferase, 6-Thioguanine, Polymorphism
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