Pawlik-Gwozdecka Dorota, Irga-Jaworska Ninela, Tomaszewski Marek, Adamkiewicz-Drożyńska Elżbieta
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland.
Contemp Oncol (Pozn). 2018;22(4):266-269. doi: 10.5114/wo.2018.82646. Epub 2018 Dec 31.
Sinusoidal obstruction syndrome (SOS), also termed veno-occlusive disease (VOD) of the liver, is a well-known complication of haematopoietic stem cell transplantation (HSCT) both in children and adults. In the medical literature there are occasional reports of SOS in patients receiving conventional chemotherapy. In children with solid tumours this entity occurs during treatment of nephroblastoma, rhabdomyosarcoma, and medulloblastoma. In the late 1990s SOS was quite often observed as the complication of oral 6-thioguanine (6-TG) in patients suffering from acute lymphoblastic leukaemia (ALL), who received 6-TG throughout maintenance. In current protocols, the syndrome has become uncommon because treatment with 6-TG is limited to two weeks of oral therapy. Here, we report a case of a nine-year-old boy with ALL, who developed sinusoidal obstruction syndrome shortly after completing the reinduction block of chemotherapy (cyclophosphamide, cytarabine, thioguanine) according to the ALL Intercontinental Berlin-Frankfurt-Münster 2009 (ALL IC BFM 2009) treatment protocol.
窦性阻塞综合征（SOS），也称为肝静脉闭塞病（VOD），是儿童和成人造血干细胞移植（HSCT）中一种众所周知的并发症。在医学文献中，偶尔有接受传统化疗的患者发生SOS的报道。在患有实体瘤的儿童中，这种情况发生在肾母细胞瘤、横纹肌肉瘤和髓母细胞瘤的治疗期间。在20世纪90年代后期，在接受维持期全程口服6-硫鸟嘌呤（6-TG）的急性淋巴细胞白血病（ALL）患者中，SOS经常被观察到是口服6-TG的并发症。在当前方案中，该综合征已变得不常见，因为6-TG的治疗仅限于两周的口服治疗。在此，我们报告一例9岁ALL男孩病例，该男孩在按照2009年ALL洲际柏林-法兰克福-明斯特（ALL IC BFM 2009）治疗方案完成化疗再诱导阶段（环磷酰胺、阿糖胞苷、硫鸟嘌呤）后不久发生了窦性阻塞综合征。
