Journal of pediatric hematology/oncology
July 21, 2026 · via Europe PMC
Severe Veno-Occlusive Disease in a Child With Wilms Tumor: Acute Management and Subsequent Bridging With Irinotecan Treatment.
Chumsky J, Rahim M, Offenbacher R, Mullen EA, Shlomovich M, Loeb DM, Weiser D.
AI summary — for doctors, generated from the abstract only
A child with Wilms tumor who developed severe hepatic veno-occlusive disease after dactinomycin and vincristine recovered with MARS liver support and irinotecan-vincristine bridging before dactinomycin rechallenge.
What was studied
Case report of pediatric Wilms tumor complicated by severe VOD.
Key findings
- VOD occurred after dactinomycin and vincristine
- Molecular adsorbent recirculating system used for acute liver failure
- Irinotecan plus vincristine used as low-hepatotoxic bridge
- Remains in remission without long-term VOD complications
Clinical relevance
This suggests options for managing chemotherapy-induced VOD in Wilms tumor while maintaining disease control.
Who should care
Limitations
Single case report.
Liver support and a bridging regimen allowed a child with Wilms tumor to recover from severe VOD.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
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.
DOI
10.1097/mph.0000000000003253
PMID
42479499
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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