title: Long-term risk of portal hypertension and related complications in children treated with 6-thioguanine for acute lymphoblastic leukemia: A single-center experience.
abstract: Long-term follow-up of 11 children with 6-thioguanine-induced hepatoportal toxicity is described. Features of persistent portal hypertension in eight patients after 9.7 ± 3.4 years (mean ± SD) of treatment were more common in late presenters. Splenomegaly, thrombocytopenia and altered hepatic echotexture were seen in six, eight and seven patients, respectively. One of the thrombocytopenic patients had heavy menstrual bleeding and pregnancy loss. Five of six patients who underwent upper gastrointestinal endoscopy had esophageal varices and four underwent banding. Late presentation in a subset of patients mandates long-term surveillance and follow-up for all patients treated with 6-thioguanine for early detection and management of hepatoportal complications.
authors.affiliation: Department of Paediatrics, The Royal Marsden Hospital, Sutton, SM2 5PT, UK.
authors.forename: Nirmalya
authors.initials: N
authors.lastname: Roy Moulik
authors.affiliation: Department of Paediatrics, The Royal Marsden Hospital, Sutton, SM2 5PT, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: M Taj
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000453:epidemiology*; D012307:Risk Factors; D013163:Splenomegaly / Q000139:chemically induced / Q000453:epidemiology; D013866:Thioguanine / Q000008:administration & dosage / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000453:epidemiology; D013997:Time Factors
chemical_list: D013866:Thioguanine
keywords: 6-thioguanine; complications; hepatoportal toxicity