Antineoplastics
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Reactions 1407 - 23 Jun 2012 S Antineoplastics Various toxicities: 3 case reports Three women with ovarian cancer developed various toxicities [times to onsets not stated] during treatment with the VPCBAE regimen comprising vinblastine, cisplatin, cyclophosphamide, bleomycin, doxorubicin and etoposide. All of the women underwent salpingo- oophorectomy, and were scheduled to receive 6 cycles of chemotherapy with VPCBAE as follows: IV vinblastine 6 mg/m 2 over 30 minutes on day 1, IV cisplatin 90 mg/m 2 over 4 hours on day 1, IV cyclophosphamide 1000 mg/m 2 over 60 minutes on day 2, IV bleomycin 15 units/m 2 over 24 hours on day 2, IV doxorubicin 45 mg/m 2 over 30 minutes on day 3, and IV etoposide 200 mg/m 2 over 2 hours on day 3. A 24-year-old woman developed pancytopenia, mucositis and cellulitis after her sixth cycle of VPCBAE. She recovered from complications with no long-term sequelae after she received platelet and blood transfusions, and antibacterials. A 28-year-old woman was hospitalised for nausea, vomiting, pancytopenia and neutropenic fever after her third cycle of VPCBAE. Streptococcocal bacteraemia was noted from blood cultures. She also developed acute renal insufficiency, and her creatinine level, which peaked at 3.3 mg/dL, had normalised after hydration. She received platelet and blood transfusions, and antibacterials. In her subsequent cycles of chemotherapy, the following dose reductions were applied: cisplatin to 45 mg/m 2 , cyclophosphamide to 750 mg/m 2 , doxorubicin to 30 mg/m 2 , and etoposide to 100 mg/m 2 . Her pulmonary function tests revealed decreased diffusing capacity for carbon monoxide after her fourth cycle. Bleomycin was omitted in the fifth and sixth cycles, and she completed the remaining cycles without any incidents. However, she experienced neurologic sequelae including peripheral sensory and motor neuropathy with numbness and tingling in her extremities, loss of coordination, and ambulation difficulty. Her neurologic symptoms significantly improved with gabapentin. A 26-year-old woman was admitted with neutropenic fever after her first and fifth cycles of VPCBAE. Treatment with antibacterials led to a quick recovery, and she completed her scheduled chemotherapy. Wallbillich JJ, et al. Vinblastine, cisplatin, cyclophosphamide, bleomycin, doxorubicin, and etoposide (VPCBAE) in the management of three patients with small-cell carcinoma of the ovary. Gynecologic Oncology Reports 2: 58-60, No. 2, Apr 2012. Available from: URL: http://dx.doi.org/10.1016/j.gynor.2012.02.001 - USA 803072251 1 Reactions 23 Jun 2012 No. 1407 0114-9954/10/1407-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1407 - 23 Jun 2012
SAntineoplastics
Various toxicities: 3 case reportsThree women with ovarian cancer developed various
toxicities [times to onsets not stated] during treatment withthe VPCBAE regimen comprising vinblastine, cisplatin,cyclophosphamide, bleomycin, doxorubicin andetoposide. All of the women underwent salpingo-oophorectomy, and were scheduled to receive 6 cycles ofchemotherapy with VPCBAE as follows: IV vinblastine6 mg/m2 over 30 minutes on day 1, IV cisplatin 90 mg/m2
over 4 hours on day 1, IV cyclophosphamide 1000 mg/m2
over 60 minutes on day 2, IV bleomycin 15 units/m2 over24 hours on day 2, IV doxorubicin 45 mg/m2 over30 minutes on day 3, and IV etoposide 200 mg/m2 over2 hours on day 3.
A 24-year-old woman developed pancytopenia,mucositis and cellulitis after her sixth cycle of VPCBAE. Sherecovered from complications with no long-term sequelaeafter she received platelet and blood transfusions, andantibacterials.
A 28-year-old woman was hospitalised for nausea,vomiting, pancytopenia and neutropenic fever after herthird cycle of VPCBAE. Streptococcocal bacteraemia wasnoted from blood cultures. She also developed acute renalinsufficiency, and her creatinine level, which peaked at3.3 mg/dL, had normalised after hydration. She receivedplatelet and blood transfusions, and antibacterials. In hersubsequent cycles of chemotherapy, the following dosereductions were applied: cisplatin to 45 mg/m2,cyclophosphamide to 750 mg/m2, doxorubicin to30 mg/m2, and etoposide to 100 mg/m2. Her pulmonaryfunction tests revealed decreased diffusing capacity forcarbon monoxide after her fourth cycle. Bleomycin wasomitted in the fifth and sixth cycles, and she completed theremaining cycles without any incidents. However, sheexperienced neurologic sequelae including peripheralsensory and motor neuropathy with numbness and tinglingin her extremities, loss of coordination, and ambulationdifficulty. Her neurologic symptoms significantly improvedwith gabapentin.
A 26-year-old woman was admitted with neutropenicfever after her first and fifth cycles of VPCBAE. Treatmentwith antibacterials led to a quick recovery, and shecompleted her scheduled chemotherapy.Wallbillich JJ, et al. Vinblastine, cisplatin, cyclophosphamide, bleomycin,doxorubicin, and etoposide (VPCBAE) in the management of three patients withsmall-cell carcinoma of the ovary. Gynecologic Oncology Reports 2: 58-60, No. 2,Apr 2012. Available from: URL: http://dx.doi.org/10.1016/j.gynor.2012.02.001 -USA 803072251
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Reactions 23 Jun 2012 No. 14070114-9954/10/1407-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
