Antineoplastics
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Reactions 1492, p10 - 15 Mar 2014 S Antineoplastics Liver damage: case report A 25-year-old man experienced drug-induced liver damage while receiving cisplatin, carboplatin, cyclophosphamide and etoposide [routes not stated]. The man started receiving PEB induction chemotherapy at 3-week intervals with cisplatin 20 mg/m 2 and etoposide 100 mg/m 2 on days 1–5 with bleomycin, following a diagnosis of mediastinal non-seminomatous germ cell tumour. After 3 cycles he showed partial remission. Four weeks after PEB was completed, he started receiving cisplatin 20 mg/m 2 with etoposide 100 mg/m 2 on days 1–5 followed by granulocyte macrophage colony stimulating factor. He underwent leukaphoresis 14 days later, and 4 weeks later he receiving a single course of high-dose chemotherapy with carboplatin AUC 20, etoposide 1800 mg/m 2 and cyclophosphamide 6400 mg/m 2 divided into four doses given on days 1, 2, 3 and 4. On day 7 after starting high-dose chemotherapy his AST level was 923 U/L and his ALT level was 909 U/L. The man’s liver enzyme levels slowly dropped, and normalised after 20 days. His α-fetoprotein levels increased, but normalised after 106 days. He subsequently underwent surgical resection and 5 years after induction chemotherapy he remained disease-free. Author comment: "In our patient whose serum [α- fetoprotein] levels were continuously negative before and during treatment, elevation of transaminases and [α- fetoprotein] may have been the expression of hepatic reconstitution after drug-induced liver damage. . . cisplatin, etoposide and cyclophosphamide, can induce hepatotoxicity." Burgio SL, et al. Alpha-fetoprotein surge following high-dose chemotherapy in germ cell tumours. Journal of Chemotherapy 25: 119-22, No. 2, Apr 2013 - Italy 803100354 1 Reactions 15 Mar 2014 No. 1492 0114-9954/14/1492-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1492, p10 - 15 Mar 2014
SAntineoplastics
Liver damage: case reportA 25-year-old man experienced drug-induced liver damage
while receiving cisplatin, carboplatin, cyclophosphamide andetoposide [routes not stated].
The man started receiving PEB induction chemotherapy at3-week intervals with cisplatin 20 mg/m2 and etoposide100 mg/m2 on days 1–5 with bleomycin, following a diagnosisof mediastinal non-seminomatous germ cell tumour. After3 cycles he showed partial remission. Four weeks after PEBwas completed, he started receiving cisplatin 20 mg/m2 withetoposide 100 mg/m2 on days 1–5 followed by granulocytemacrophage colony stimulating factor. He underwentleukaphoresis 14 days later, and 4 weeks later he receiving asingle course of high-dose chemotherapy with carboplatinAUC 20, etoposide 1800 mg/m2 and cyclophosphamide6400 mg/m2 divided into four doses given on days 1, 2, 3 and4. On day 7 after starting high-dose chemotherapy his ASTlevel was 923 U/L and his ALT level was 909 U/L.
The man’s liver enzyme levels slowly dropped, andnormalised after 20 days. His α-fetoprotein levels increased,but normalised after 106 days. He subsequently underwentsurgical resection and 5 years after induction chemotherapy heremained disease-free.
Author comment: "In our patient whose serum [α-fetoprotein] levels were continuously negative before andduring treatment, elevation of transaminases and [α-fetoprotein] may have been the expression of hepaticreconstitution after drug-induced liver damage. . . cisplatin,etoposide and cyclophosphamide, can induce hepatotoxicity."Burgio SL, et al. Alpha-fetoprotein surge following high-dose chemotherapy ingerm cell tumours. Journal of Chemotherapy 25: 119-22, No. 2, Apr 2013 -Italy 803100354
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Reactions 15 Mar 2014 No. 14920114-9954/14/1492-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
