Sinusoidal Obstruction Syndrome Following Myeloablative Therapy and Tranexamic Acid Treatment for Hemorrhage in Two Patients with Neuroblastoma.

Abstract

Adverse thromboembolic events following administration of the anti-fibrinolytic agent tranexamic acid (TA), used to prevent/treat excessive blood loss, are rare. We present the clinical course of two young patients (22 and 56 months) receiving busulfan/melphalan (Bu/Mel) high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) to treat high-risk neuroblastoma, who developed hepatic sinusoidal obstruction syndrome (SOS) within 48 h after systemic TA treatment for a hemodynamically relevant hemorrhage. Defibrotide treatment resolved hepatic SOS, but the short time between TA administration and SOS onset suggests a causal association.

• Authors: Felix Zirngibl, Carina Flemmig, Peter Lang, Annette Künkele, Angelika Eggert, Johannes H Schulte, Hedwig E Deubzer
• Journal: Children (Basel, Switzerland) (Children (Basel)) Vol. 7 Issue 11 (Oct 28 2020) ISSN: 2227-9067 [Print] Switzerland
• PMID: 33126407 (Publication Type: Case Reports)