Antineoplastics
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Reactions 1380 - 3 Dec 2011 S Antineoplastics Neutropenia, fever and pericardial effusion: 4 case reports Four patients with chronic active Epstein-Barr virus developed grade 4 neutropenia while receiving CHOP chemotherapy. Two patients also developed fever and pericardial effusion during treatment with high-dose cytarabine (3 g/m 2 every 12 hours on days 1 and 2). CHOP consisted of cyclophosphamide 750 mg/m 2 on day 1, doxorubicin 50 mg/m 2 on day 1, vincristine 1.4 mg/m 2 on day 1 and prednisone 100mg on days 1-5 [routes and durations of treatment to reactions onset not stated]. A 48-year-old man began receiving ciclosporin and prednisolone, followed by CHOP. He developed neutropenia which lasted for 4 days. Cytarabine was added to his regimen, but was discontinued after the second dose due to grade 4 fever and grade 4 pericardial effusion. His symptoms resolved, and he received asparaginase and methotrexate. He underwent bone marrow transplantation (BMT), followed by conditioning therapy with fludarabine, melphalan and total body irradiation. At last follow-up, he had been in remission for 25 months. A 28-year-old man started receiving ciclosporin and prednisolone, followed by CHOP; vincristine was subsequently discontinued due to neuropathy. He developed neutropenia which was sustained for 8 days. Cytarabine was added to his regimen, but was discontinued after the second dose due to grade 3 fever and grade 4 pericardial effusion. He underwent BMT, followed by conditioning therapy with fludarabine, melphalan and total body irradiation. At last follow-up, he had been in remission for 22 months. A 37-year-old woman, who was diagnosed with systemic lupus erythematosus at the age of 24 years, began receiving ciclosporin and prednisolone, followed by CHOP. She developed neutropenia which lasted for 9 days. She underwent BMT, followed by conditioning therapy with fludarabine, melphalan and total body irradiation. However, her disease relapsed and she began receiving chemotherapy 4 years after BMT. A 72-year-old woman was diagnosed with EBV-positive T-cell lymphoproliferative disorder, and started receiving ciclosporin and prednisolone, followed by CHOP. She developed neutropenia which was sustained for 5 days. Nineteen days after starting CHOP, she died from multiorgan failure due to disease progression. Arai A, et al. Clinical features of adult-onset chronic active Epstein-Barr virus infection: a retrospective analysis. International Journal of Hematology 93: 602-9, No. 5, May 2011 - Japan 803063481 1 Reactions 3 Dec 2011 No. 1380 0114-9954/10/1380-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1380 - 3 Dec 2011
SAntineoplastics
Neutropenia, fever and pericardial effusion:4 case reports
Four patients with chronic active Epstein-Barr virusdeveloped grade 4 neutropenia while receiving CHOPchemotherapy. Two patients also developed fever andpericardial effusion during treatment with high-dosecytarabine (3 g/m2 every 12 hours on days 1 and 2). CHOPconsisted of cyclophosphamide 750 mg/m2 on day 1,doxorubicin 50 mg/m2 on day 1, vincristine 1.4 mg/m2 onday 1 and prednisone 100mg on days 1-5 [routes anddurations of treatment to reactions onset not stated].
A 48-year-old man began receiving ciclosporin andprednisolone, followed by CHOP. He developedneutropenia which lasted for 4 days. Cytarabine was addedto his regimen, but was discontinued after the second dosedue to grade 4 fever and grade 4 pericardial effusion. Hissymptoms resolved, and he received asparaginase andmethotrexate. He underwent bone marrow transplantation(BMT), followed by conditioning therapy with fludarabine,melphalan and total body irradiation. At last follow-up, hehad been in remission for 25 months.
A 28-year-old man started receiving ciclosporin andprednisolone, followed by CHOP; vincristine wassubsequently discontinued due to neuropathy. Hedeveloped neutropenia which was sustained for 8 days.Cytarabine was added to his regimen, but wasdiscontinued after the second dose due to grade 3 fever andgrade 4 pericardial effusion. He underwent BMT, followedby conditioning therapy with fludarabine, melphalan andtotal body irradiation. At last follow-up, he had been inremission for 22 months.
A 37-year-old woman, who was diagnosed with systemiclupus erythematosus at the age of 24 years, began receivingciclosporin and prednisolone, followed by CHOP. Shedeveloped neutropenia which lasted for 9 days. Sheunderwent BMT, followed by conditioning therapy withfludarabine, melphalan and total body irradiation.However, her disease relapsed and she began receivingchemotherapy 4 years after BMT.
A 72-year-old woman was diagnosed with EBV-positiveT-cell lymphoproliferative disorder, and started receivingciclosporin and prednisolone, followed by CHOP. Shedeveloped neutropenia which was sustained for 5 days.Nineteen days after starting CHOP, she died frommultiorgan failure due to disease progression.Arai A, et al. Clinical features of adult-onset chronic active Epstein-Barr virusinfection: a retrospective analysis. International Journal of Hematology 93: 602-9,No. 5, May 2011 - Japan 803063481
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Reactions 3 Dec 2011 No. 13800114-9954/10/1380-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
