Portal vein thrombosis during antineoplastic chemotherapy in children: report of five cases and review of the literature.
We report five paediatric cases of portal vein thrombosis (PVT) occurring during chemotherapy, observed in two institutions over an 8-year time period. These children aged 2.5-15 years were treated for Burkitt's lymphoma, Ewing's tumour, small cell bone tumour or medulloblastoma. PVT was diagnosed on colour Doppler ultrasonography (US). In four patients, thrombosis occurred 2-45 days after severe hepatic veno-occlusive disease (HVOD) secondary to intensive chemotherapy containing busulfan. In one case, PVT occurred in the absence of HVOD in a patient with pre-existing periportal lymphomatous infiltration. Four patients experienced persistent portal hypertension, which resulted in death in one. PVT during chemotherapy in children is a rare event and appears to be closely related to intensive chemotherapy containing busulfan and to be associated with HVOD.
Brisse
H
H
Imaging Department, Institut Curie, 26 rue d'Ulm, 75005 Paris, France. herve.brisse@curie.net
Orbach
D
D
Lassau
N
N
Servois
V
V
Doz
F
F
Debray
D
D
Helfre
S
S
Hartmann
O
O
Neuenschwander
S
S
D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D011169:Portal Vein; D012307:Risk Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000188:drug therapy
D000925:Anticoagulants; D000970:Antineoplastic Agents; D006493:Heparin