Antineoplastics
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Reactions 1197 - 12 Apr 2008 ★ S Antineoplastics Thyroid cancer (first report with busulfan and thiotepa) in a child: case report An approximately 6-year-old girl developed thyroid cancer after chemotherapy with busulfan, ifosfamide, melphalan and thiotepa for pleuropulmonary blastoma (PPB). The girl was diagnosed with PPB at the age of 3 years. She had only a partial response to first line therapy, and intensified therapy with double bone marrow transplantation was initiated. She received ifosfamide 12.5 g/m 2 and melphalan 210 mg/m 2 as a first therapy regimen, and busulfan 20 mg/kg and thiotepa 800 mg/m 2 as a second regimen [frequencies of administration and duration of specific treatments not stated]; chemotherapy was administered for 7 months. She developed swelling in her right cervical region 3 years after PPB diagnosis, and ultrasound and CT scans showed multiple nodules in her right thyroid lobe [time to reaction onset not clearly stated]. Cold nodules were revealed by thyroid scintigraphy. An adenomatous goitre was diagnosed and the girl underwent right hemithyroidectomy. Histology of the resected specimen showed follicular carcinoma invading the tissue beyond the tumour capsule. Tumour recurrence in her left thyroid lobe and in her cervical lymph nodes was noted 5 months later. The remaining thyroid lobe was excised and she underwent bilateral radical neck dissection, followed by radioiodine therapy. At last observation, she had remained tumour-free for 3 years. Author comment: "There are two possible etiological causes of the thyroid carcinoma arising after treatment of the patient for PPB; one is an existing unknown genetic disorder that caused both PPB and thyroid cancer, the other is that the thyroid cancer arose as a second malignancy caused by high dose chemotherapy." Oue T, et al. Pediatric thyroid cancer arising after treatment for pleuropulmonary blastoma. Pediatric Blood and Cancer 50: 901-902, No. 4, Apr 2008 - Japan 801103712 » Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of thyroid cancer associated with busulfan or thiotepa. The WHO Adverse Drug Reactions database contained no reports of malignant thyroid neoplasm associated with busulfan or thiotepa. 1 Reactions 12 Apr 2008 No. 1197 0114-9954/10/1197-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1197 - 12 Apr 2008
★ SAntineoplastics
Thyroid cancer (first report with busulfan andthiotepa) in a child: case report
An approximately 6-year-old girl developed thyroid cancerafter chemotherapy with busulfan, ifosfamide, melphalan andthiotepa for pleuropulmonary blastoma (PPB).
The girl was diagnosed with PPB at the age of 3 years. Shehad only a partial response to first line therapy, and intensifiedtherapy with double bone marrow transplantation wasinitiated. She received ifosfamide 12.5 g/m2 and melphalan210 mg/m2 as a first therapy regimen, and busulfan 20 mg/kgand thiotepa 800 mg/m2 as a second regimen [frequencies ofadministration and duration of specific treatments not stated];chemotherapy was administered for 7 months. She developedswelling in her right cervical region 3 years after PPB diagnosis,and ultrasound and CT scans showed multiple nodules in herright thyroid lobe [time to reaction onset not clearly stated].Cold nodules were revealed by thyroid scintigraphy.
An adenomatous goitre was diagnosed and the girlunderwent right hemithyroidectomy. Histology of the resectedspecimen showed follicular carcinoma invading the tissuebeyond the tumour capsule. Tumour recurrence in her leftthyroid lobe and in her cervical lymph nodes was noted5 months later. The remaining thyroid lobe was excised andshe underwent bilateral radical neck dissection, followed byradioiodine therapy. At last observation, she had remainedtumour-free for 3 years.
Author comment: "There are two possible etiologicalcauses of the thyroid carcinoma arising after treatment of thepatient for PPB; one is an existing unknown genetic disorderthat caused both PPB and thyroid cancer, the other is that thethyroid cancer arose as a second malignancy caused by highdose chemotherapy."Oue T, et al. Pediatric thyroid cancer arising after treatment for pleuropulmonaryblastoma. Pediatric Blood and Cancer 50: 901-902, No. 4, Apr 2008 -Japan 801103712
» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of thyroidcancer associated with busulfan or thiotepa. The WHO AdverseDrug Reactions database contained no reports of malignantthyroid neoplasm associated with busulfan or thiotepa.
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Reactions 12 Apr 2008 No. 11970114-9954/10/1197-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
