Sinusoidal Obstruction Syndrome of the Liver Associated With 6-Mercaptopurine During Maintenance in a Child With T-cell Acute Lymphoblastic Leukemia

J Pediatr Hematol Oncol. 2023 Jan 1;45(1):e121-e123. doi: 10.1097/MPH.0000000000002536. Epub 2022 Aug 25.

Abstract

Sinusoidal obstruction syndrome (SOS) of the liver is a complication of chemotherapy most often encountered with hematopoietic stem cell transplant due to high-dose conditioning regimens, but it can also occur with regimens outside of the transplant setting. Mild-to-moderate SOS is a well-described 6-thioguanine toxicity; however, it has rarely been reported as secondary to 6-mercaptopurine, a related thiopurine. This report details a case of a 10-year-old male with T-cell acute lymphoblastic leukemia who developed severe SOS during maintenance therapy with 6-mercaptopurine, and a review of the related literature.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Hepatic Veno-Occlusive Disease* / etiology
  • Humans
  • Male
  • Mercaptopurine
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma* / complications
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy
  • T-Lymphocytes
  • Thioguanine / adverse effects

Substances

  • Mercaptopurine
  • Thioguanine