Successful treatment of doxorubicin and cisplatin resistant hepatoblastoma in a child with Beckwith-Wiedemann syndrome with high dose acetaminophen and N-acetylcysteine rescue

High dose acetaminophen (HDAC) with N‐acetylcysteine (NAC) has been effective in adults with advanced malignancies. We report HDAC with NAC in a child with progressive hepatoblastoma, confirmed at biopsy of an unresectable hepatic mass. Alpha‐fetoprotein (AFP) increased despite four courses of doxor...

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Bibliographic Details
Published in:Pediatric blood & cancer 2005-08, Vol.45 (2), p.222-225
Main Authors: Kobrinsky, Nathan L., Sjolander, Diane E., Goldenberg, Jacob A., Ortmeier, Thomas C.
Format: Article
Language:English
Subjects:
acetaminophen
Acetaminophen - administration & dosage
Acetylcysteine - therapeutic use
Antineoplastic Agents - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - pharmacology
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Beckwith-Wiedemann
Beckwith-Wiedemann Syndrome - complications
Biological and medical sciences
Cisplatin - administration & dosage
Cisplatin - pharmacology
cisplatin-resistance
Doxorubicin - pharmacology
doxorubicin-resistance
Drug Resistance, Neoplasm
Drug Therapy, Combination
Female
General aspects
hepatoblastoma
Hepatoblastoma - complications
Hepatoblastoma - drug therapy
Hepatoblastoma - pathology
Humans
Infant
Liver Neoplasms - complications
Liver Neoplasms - drug therapy
Liver Neoplasms - pathology
Medical sciences
N-acetylcysteine
Tumors
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Summary:High dose acetaminophen (HDAC) with N‐acetylcysteine (NAC) has been effective in adults with advanced malignancies. We report HDAC with NAC in a child with progressive hepatoblastoma, confirmed at biopsy of an unresectable hepatic mass. Alpha‐fetoprotein (AFP) increased despite four courses of doxorubicin and one course of cisplatin, 5‐flurouracil, and vincristine. Following HDAC with NAC, AFP markedly decreased. A continued response without toxicity was observed during four subsequent courses of HDAC with NAC and cisplatin. The residual necrotic tumor was resected. The child is now over 8 years disease free. HDAC and NAC are effective and well tolerated for progressive hepatoblastoma. © 2005 Wiley‐Liss, Inc.
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.20330