Hepatic sinusoidal obstruction syndrome in South African children treated for Wilms tumour: prevalence, risk factors and outcomes
Date
2014-04-01
Authors
Andrade, Anabela De Sousa
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Wilms Tumour (WT) is one of the commonest tumours in children. Hepatic Sinusoidal Obstruction Syndrome (HSOS) is a documented complication following treatment of WT.
The role of malnutrition in the development of HSOS has not been studied. Malnutrition reduces tolerance to chemotherapy and shows increased risk for toxicity.
Purpose of study
To determine the prevalence of HSOS in children with WT, as well as its predisposing factors and outcomes.
Method
A descriptive retrospective analysis of medical records of children treated for WT, who developed HSOS, at the Paediatric Haematology/Oncology Unit, Chris Hani Baragwanath Hospital.
Results
82 patients were evaluated. 19 (23%) showed features compatible with HSOS. Younger age, irradiation and a right-sided WT predicted the development of HSOS but were not statistically significant. Serum albumin levels were lower in the affected group (P = 0.02). Apart from 2 deaths, outcomes were good, with patients showing full resolution of symptoms.
Conclusion
A higher prevalence of HSOS was shown than previously reported. Low serum albumin levels points to the role of malnutrition. Effort needs to be put into the various methods of identifying malnutrition. Long term follow-up is needed.