VENOOCCLUSIVE DISEASE-LIKE HEPATOTOXICITY IN 2 CHILDREN RECEIVING CHEMOTHERAPY FOR WILMS-TUMOR AND CLEAR-CELL SARCOMA OF KIDNEY

We report two pediatric cases who developed veno-occlusive disease-lik e hepatotoxicity while receiving chemotherapy for Wilms' tumor and cle ar cell sarcoma of kidney. The chemotherapeutics, including-vincristin e, actinomycin D, and epirubicin in case I and vincristine and actinom ycin D in case 2, were given before the hepatotoxicity developed. Othe r possible causes of hepatotoxicity were excluded. Recovery was observ ed with supportive therapy after 2 and 1 weeks, respectively. After re covery, the children tolerated continued chemotherapy without any decr ease in the doses of drugs. We conclude that vincristine and actinomyc in D were the cause of this rare form of hepatotoxicity and that chemo therapy for the underlying malignant disease could be given safely aft er clinical recovery.