A stitch in time saves nine: timely use of N-acetyl cysteine (NAC) for chemotherapy-induced veno-occlusive disease (VOD)-is it a cost-effective alternative?

Support Care Cancer. 2022 Nov;30(11):8611-8614. doi: 10.1007/s00520-022-07321-x. Epub 2022 Aug 13.

Abstract

Chemotherapy-induced veno-occlusive disease (VOD) is a rare liver dysfunction seen among pediatric cancer patients which could lead to severe morbidity and mortality. Defibrotide is the commonly used antidote in the management of both stem cell transplant and chemotherapy-associated VOD along with liver supportive measures. Defibrotide is costly and generally not accessible to majority of patients treated at resource poor settings. In this report, we describe the successful management of chemotherapy-induced VOD with timely administration of N-acetyl cysteine.

Keywords: Chemotherapy; Defibrotide; N-Acetyl cysteine; Veno-occlusive disease.

MeSH terms

  • Acetylcysteine / therapeutic use
  • Antineoplastic Agents* / adverse effects
  • Child
  • Cost-Benefit Analysis
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hepatic Veno-Occlusive Disease* / drug therapy
  • Hepatic Veno-Occlusive Disease* / therapy
  • Humans
  • Polydeoxyribonucleotides / pharmacology
  • Vascular Diseases* / drug therapy
  • Vascular Diseases* / etiology

Substances

  • Polydeoxyribonucleotides
  • Acetylcysteine
  • Antineoplastic Agents