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Long‐term risk of portal hypertension and related complications in children treated with 6‐thioguanine for acute lymphoblastic leukemia: A single‐center experience
Author(s) -
Roy Moulik Nirmalya,
M Taj Mary
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26495
Subject(s) - medicine , esophageal varices , portal hypertension , single center , presentation (obstetrics) , gastroenterology , pediatrics , surgery , cirrhosis
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.