BACKGROUND/AIMS: The United Kingdom (UK) acute lymphoblastic leukaemia (ALL) 97/99 clinical trial compared 6-mercaptopurine (6MP) with 6-thioguanine (6TG) as maintenance therapy for childhood ALL. Review of interim results has led to discontinuation of the 6TG arm. METHODS: We report six children with ALL, who presented with splenomegaly after a median (range) treatment duration of 12 (6-22) months. All these children were treated in the 6TG-arm. RESULTS: The median (range) age at presentation was 6.6 (3.2-11.5) years. There were five boys. The presenting features were splenomegaly in all and hepatomegaly in four. AST was abnormal in one (80 IU/l, normal range 10-50). Abdominal sonography showed an altered texture of the liver parenchyma and confirmed splenomegaly. Microscopy showed findings within the spectrum of occlusive venopathy and nodular regenerative hyperplasia (NRH). After a median (range) follow-up of 23 (4-36) months splenomegaly and thrombocytopenia, suggestive of progressive portal hypertension, continue to worsen in all children. CONCLUSIONS: 6TG is associated with chronic hepatic toxicity and progressive portal hypertension on follow-up. Microscopy showed NRH in all patients with features in keeping with an intrahepatic occlusive venopathy and variable parenchymal atrophy and loss.
BACKGROUND/AIMS: The United Kingdom (UK) acute lymphoblastic leukaemia (ALL) 97/99 clinical trial compared 6-mercaptopurine (6MP) with 6-thioguanine (6TG) as maintenance therapy for childhood ALL. Review of interim results has led to discontinuation of the 6TG arm. METHODS: We report six children with ALL, who presented with splenomegaly after a median (range) treatment duration of 12 (6-22) months. All these children were treated in the 6TG-arm. RESULTS: The median (range) age at presentation was 6.6 (3.2-11.5) years. There were five boys. The presenting features were splenomegaly in all and hepatomegaly in four. AST was abnormal in one (80 IU/l, normal range 10-50). Abdominal sonography showed an altered texture of the liver parenchyma and confirmed splenomegaly. Microscopy showed findings within the spectrum of occlusive venopathy and nodular regenerative hyperplasia (NRH). After a median (range) follow-up of 23 (4-36) months splenomegaly and thrombocytopenia, suggestive of progressive portal hypertension, continue to worsen in all children. CONCLUSIONS:6TG is associated with chronic hepatic toxicity and progressive portal hypertension on follow-up. Microscopy showed NRH in all patients with features in keeping with an intrahepatic occlusive venopathy and variable parenchymal atrophy and loss.
Authors: Sharon Castellino; Andrew Muir; Ami Shah; Sheila Shope; Kevin McMullen; Kathy Ruble; Ashley Barber; Andrew Davidoff; Melissa M Hudson Journal: Pediatr Blood Cancer Date: 2010-05 Impact factor: 3.167
Authors: Alexander Teml; Matthias Schwab; Daan W Hommes; Sven Almer; Milan Lukas; Thomas Feichtenschlager; Timothy Florin; Julia Seiderer; Wolfgang Petritsch; Bernd Bokemeyer; Wolfgang Kreisel; Klaus R Herrlinger; Peter Knoflach; Bruno Bonaz; Thomas Klugmann; Hans Herfarth; Nikolaus Pedarnig; Walter Reinisch Journal: Wien Klin Wochenschr Date: 2007 Impact factor: 1.704
Authors: Eric J Chow; Lynnette Anderson; K Scott Baker; Smita Bhatia; Gregory M T Guilcher; Jennifer T Huang; Wendy Pelletier; Joanna L Perkins; Linda S Rivard; Tal Schechter; Ami J Shah; Karla D Wilson; Kenneth Wong; Satkiran S Grewal; Saro H Armenian; Lillian R Meacham; Daniel A Mulrooney; Sharon M Castellino Journal: Biol Blood Marrow Transplant Date: 2016-01-21 Impact factor: 5.742
Authors: Ahmed B Bayoumy; Elsa L S A van Liere; Melek Simsek; Ben Warner; Aathavan Loganayagam; Jeremy D Sanderson; Simon Anderson; Jonathan Nolan; Nanne K de Boer; Chris J J Mulder; Azhar Ansari Journal: BMC Gastroenterol Date: 2020-09-11 Impact factor: 3.067