Antineoplastics
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Reactions 1256 - 13 Jun 2009 S Antineoplastics Neutropenia and mucosal disorders: case report An about 37-year-old man developed neutropenia and severe mucositis, culminating in regurgitation of his oesophageal mucosa, while receiving high-dose chemotherapy with carmustine, etoposide, cytarabine [Aracytine] and melphalan [dosages and duration of treatments to onset of reactions not stated]. The man had been diagnosed with stage IV nodular sclerosing Hodgkin lymphoma in 2005, aged 35 years, and had undergone treatment according to the ABVD regimen (doxorubicin, bleomycin, vincristine and dacarbazine). He presented with mediastinal relapse in 2007. After three courses of MINE therapy (mitoguazone, ifosfamide, vinorelbine and etoposide), high-dose chemotherapy with carmustine, etoposide, cytarabine and melphalan (BEAM) was initiated; he also underwent autologous stem cell transplantation. While receiving BEAM, he developed intractable nausea, severe oral mucositis and grade IV neutropenia. On examination on day +20, he reported severe throat pain and nausea, and subsequently regurgitated a long red and white flesh-like object, which was identified as his entire oesophageal mucosa. Further investigations of the expelled specimen revealed mucosal necrosis with preservation of the basal membrane. Subsequent clinical examination showed no abnormalities, bleeding or choking. He made an uneventful recovery without evidence of oesophageal dysfunction [neutropenia outcome not stated]. Author comment: "This spectacular case demonstrates the extensive damage caused by chemotherapies on the mucosa . . . repeated episodes of vomiting may have favored the regurgitation of the damaged esophageal mucosa." Canaud G, et al. Clinical challenges and images in GI. Gastroenterology 136: 1508 & 1847, No. 5, May 2009 - France 801146019 1 Reactions 13 Jun 2009 No. 1256 0114-9954/10/1256-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1256 - 13 Jun 2009
SAntineoplastics
Neutropenia and mucosal disorders: case reportAn about 37-year-old man developed neutropenia and
severe mucositis, culminating in regurgitation of hisoesophageal mucosa, while receiving high-dosechemotherapy with carmustine, etoposide, cytarabine[Aracytine] and melphalan [dosages and duration oftreatments to onset of reactions not stated].
The man had been diagnosed with stage IV nodularsclerosing Hodgkin lymphoma in 2005, aged 35 years, andhad undergone treatment according to the ABVD regimen(doxorubicin, bleomycin, vincristine and dacarbazine). Hepresented with mediastinal relapse in 2007. After threecourses of MINE therapy (mitoguazone, ifosfamide,vinorelbine and etoposide), high-dose chemotherapy withcarmustine, etoposide, cytarabine and melphalan (BEAM)was initiated; he also underwent autologous stem celltransplantation. While receiving BEAM, he developedintractable nausea, severe oral mucositis and grade IVneutropenia. On examination on day +20, he reportedsevere throat pain and nausea, and subsequentlyregurgitated a long red and white flesh-like object, whichwas identified as his entire oesophageal mucosa. Furtherinvestigations of the expelled specimen revealed mucosalnecrosis with preservation of the basal membrane.Subsequent clinical examination showed no abnormalities,bleeding or choking. He made an uneventful recoverywithout evidence of oesophageal dysfunction [neutropeniaoutcome not stated].
Author comment: "This spectacular case demonstrates theextensive damage caused by chemotherapies on themucosa . . . repeated episodes of vomiting may have favoredthe regurgitation of the damaged esophageal mucosa."Canaud G, et al. Clinical challenges and images in GI. Gastroenterology 136: 1508& 1847, No. 5, May 2009 - France 801146019
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Reactions 13 Jun 2009 No. 12560114-9954/10/1256-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
