Severe Veno-Occlusive Disease in a Child With Wilms Tumor: Acute Management and Subsequent Bridging With Irinotecan Treatment
Abstract
BACKGROUND: Hepatic veno-occlusive disease (VOD) is an endothelial injury seen after stem cell transplantation that can also occur with conventional chemotherapies. Morbidity can be significant, highlighting the need for effective supportive care. CASE REPORT: We present a pediatric patient with Wilms tumor who developed VOD after dactinomycin and vincristine. Management included a molecular adsorbent recirculating system (MARS) for acute liver failure and irinotecan with vincristine (VI) as bridging chemotherapy before gradual reintroduction of dactinomycin. CONCLUSION: The patient remains in remission without long-term VOD complications. MARS facilitated hepatic recovery, and disease control was maintained with VI serving as a low-hepatotoxic bridging regimen before rechallenging with dactinomycin.
Fields of Study & Subjects
Renal and related cancers
Hepatocellular Carcinoma Treatment and Prognosis
Chemotherapy-induced organ toxicity mitigation
Publication details
- Journal / source
- Journal of Pediatric Hematology/Oncology
- Publisher
- Ovid Technologies (Wolters Kluwer Health)
- Volume
- 48
- Issue
- 7
- Pages
- e308-e311
- Publication date
- 21 July 2026
- Language
- EN