Treatment of Sinusoidal Obstruction Syndrome With Defibrotide in Pediatric Cancer Patients Following Nontransplant-associated Chemotherapy: A Case Report and Review of the Literature

J Pediatr Hematol Oncol. 2022 Apr 1;44(3):e788-e791. doi: 10.1097/MPH.0000000000002177.

Abstract

Sinusoidal obstruction syndrome (SOS), formerly veno-occlusive disease (VOD), in pediatric cancer patients often presents as a complication of hematopoietic stem cell transplantation, and less commonly secondary to nontransplant-associated chemotherapy. Therapy with defibrotide is well-described as standard care for transplant-associated SOS/VOD, but the treatment of nontransplant-associated SOS/VOD is less clear. We report a 3-year-old with relapsed Wilms tumor and recurrent SOS/VOD, with successful use of defibrotide during chemotherapy. A review of pediatric cancer patients with nontransplant-associated SOS/VOD treated with defibrotide revealed 83 patients, and 66 were in remission. This review supports early treatment with defibrotide in patients with nontransplant-associated SOS/VOD.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hepatic Veno-Occlusive Disease* / chemically induced
  • Hepatic Veno-Occlusive Disease* / drug therapy
  • Humans
  • Kidney Neoplasms* / drug therapy
  • Male
  • Neoplasm Recurrence, Local / drug therapy
  • Polydeoxyribonucleotides / therapeutic use

Substances

  • Polydeoxyribonucleotides
  • defibrotide