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Medline ® Abstract for Reference 15

of 'Chemotherapy hepatotoxicity and dose modification in patients with liver disease'

15
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Veno-occlusive disease in patients receiving thiopurines during maintenance therapy for childhood acute lymphoblastic leukaemia.
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Stoneham S, Lennard L, Coen P, Lilleyman J, Saha V
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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.
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Cancer Research UK, Children's Cancer Group, Bart's and The London, Queen Mary School of Medicine and Dentistry, London, UK. sara.stoneham@cancer.org.uk
PMID