Báo cáo một trường hợp viêm tụy cấp do 6-Mercaptopurine ở bệnh nhi bạch cầu cấp dòng lympho B=Case report of acute pancreatitis due to 6-Mercaptopurine in a child with B-cell acute lymphoblastic leukemia

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Tác giả: Thị Thu Ngân Cai, Châu Minh Thư Hồ, Thị Thanh Trúc Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.329-334

Bộ sưu tập: Báo, Tạp chí

ID: 478271

Thêm vào giỏ

Mercaptopurine (6- mercaptopurine, 6-MP) is a crucial component in the maintenance phase of treatment and contributes to improving overall survival rates in pediatric acute lymphoblastic leukemia (ALL). While 6-MP is well-tolerated by a majority of patients, some children experience significant side effects which can result in substantial pauses in therapy or dose reductions that may affect long-term outcomes and influence quality of life. Notably, the most significant side effects are gastrointestinal ones such as nausea, pancreatitis, and hepatotoxicity. Case Report: We present a case of a 13-year-old female pediatric patient with B-cell ALL who was diagnosed with acute pancreatitis due to 6-MP after completing the first cycle of the maintenance phase. Following stabilization of pancreatitis through the use of allopurinol combined with a reduced dose of 6- MP, we observed that the patient continued to tolerate 6-MP well without recurrence of pancreatitis. Conclusion: The use of allopurinol with a reduced dose of 6-MP may be a safe and effective therapy in children with ALL who experience pancreatitis and other gastrointestinal toxicities related to 6-MP.Mercaptopurine (6- mercaptopurine, 6-MP) là một thành phần chính trong giai đoạn điều trị duy trì và góp phần vào việc cải thiện tỉ lệ sống còn toàn bộ trong bệnh cảnh bạch cầu cấp dòng lympho (BCCDL) ở trẻ em. Mặc dù 6-MP thường được dung nạp tốt, tuy nhiên một số bệnh nhi có thể gặp phải các tác dụng phụ đáng kể, dẫn đến gián đoạn quá trình điều trị hoặc giảm liều thuốc, ảnh hưởng đến kết quả dài hạn cũng như chất lượng cuộc sống. Đáng chú ý nhất là các tác dụng phụ đường tiêu hóa như buồn nôn, viêm tụy và độc tính gan. Báo cáo ca lâm sàng: Chúng tôi trình bày một trường hợp bệnh nhi nữ, 13 tuổi, BCCDL-B và được chẩn đoán viêm tụy cấp do 6-MP sau khi hoàn tất chu kì đầu tiên của giai đoạn điều trị duy trì. Sau khi tình trạng viêm tụy ổn định, thông qua việc sử dụng allopurinol kết hợp với giảm liều 6-MP, chúng tôi nhận thấy bệnh nhi vẫn dung nạp tốt với 6-MP mà không ghi nhận tình trạng viêm tụy trở lại. Kết luận: Việc sử dụng allopurinol với giảm liều 6-MP có thể là một liệu pháp an toàn và hiệu quả ở trẻ em BCCDL gặp phải tình trạng viêm tụy cũng như các độc tính đường tiêu hoá khác liên quan đến 6-MP.

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