title: Hepatic sinusoidal obstruction syndrome during chemotherapy for childhood medulloblastoma: report of a case and review of the literature.
abstract: Hepatic sinusoidal obstruction syndrome (HSOS), also known as veno-occlusive disease, is a well-recognized toxic complication after autologous and allogeneic hematopoietic stem cell transplant, during treatment of Wilms tumor and rhabdomyosarcoma associated with actinomycin-D, and during acute lymphoblastic leukemia therapy due to oral 6-thioguanine. However, its occurrence in the context of chemotherapy regimens for other childhood malignancies is rare. We report a 5-year-old girl with high-risk anaplastic medulloblastoma, who developed severe HSOS during her second cycle of maintenance chemotherapy, consisting of vincristine, cisplatin, and cyclophosphamide. She was treated with defibrotide with complete resolution of the HSOS. These findings and a review of the literature, highlight the occurrence of HSOS in children outside the established settings of hematopoietic stem cell transplantation, Wilms tumor, rhabdomyosarcoma, and acute lymphoblastic leukemia.
authors.affiliation: *Department of Haematology and Oncology, Princess Margaret Hospital for Children †Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia ‡School of Paediatrics and Child Health, University of Western Australia, Perth, WA.
authors.forename: Rishi S
authors.initials: RS
authors.lastname: Kotecha
authors.forename: Amy
authors.initials: A
authors.lastname: Buckland
authors.forename: Marianne B
authors.initials: MB
authors.lastname: Phillips
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Cole
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Gottardo
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D002528:Cerebellar Neoplasms / Q000188:drug therapy*; D002675:Child, Preschool; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced* / Q000188:drug therapy*; D006801:Humans; D008527:Medulloblastoma / Q000188:drug therapy*; D011089:Polydeoxyribonucleotides / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D011089:Polydeoxyribonucleotides; C036901:defibrotide