Medline ® Abstract for Reference 15
of 'Chemotherapy hepatotoxicity and dose modification in patients with liver disease'
Veno-occlusive disease in patients receiving thiopurines during maintenance therapy for childhood acute lymphoblastic leukaemia.
Stoneham S, Lennard L, Coen P, Lilleyman J, Saha V
Br J Haematol. 2003;123(1):100.
The case records of 99 consecutive children with acute lymphoblastic leukaemia who received either 6-thioguanine (6-TG) or 6-mercaptopurine (6-MP) as maintenance therapy for at least 1 year were reviewed for hepatic veno-occlusive disease (VOD). Overall, 12% of those on 6-TG developed VOD (all boys). Isolated persistent thrombocytopenia appeared to be the earliest indicator of incipient VOD. Multivariate analysis identified male sex and 6-TG as risk factors. In all cases, VOD was mild and reversible on withdrawing 6-TG or replacing it with 6-MP. The data implicate a sex-linked polymorphic variation in xenobiotic pathways of thiopurine metabolism in the pathogenesis of VOD.
Cancer Research UK, Children's Cancer Group, Bart's and The London, Queen Mary School of Medicine and Dentistry, London, UK. firstname.lastname@example.org