Antineoplastics
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Reactions 1411 - 21 Jul 2012 S Antineoplastics Guillain-Barre syndrome?: 2 case reports Two patients developed Guillain-Barre syndrome (GBS) while receiving chemotherapy for colorectal cancer [routes, dosages and durations of treatment to reactions onset not stated]. A 51-year-old man with stage III colon cancer began receiving trebananib [AMG 386] in combination with folinic acid, fluorouracil and irinotecan (FOLFIRI). In September 2009, after six cycles, trebananib was discontinued due to peripheral oedema. He continued to receive FOLFIRI until December 2009. The following month, he presented with a few days’ history of weakness and sensory loss in his forearms and legs. A lumbar puncture revealed elevated protein and albumin- ocytological dissociation, and nerve conduction studies were consistent with GBS. Treatment with immune globulin led to a mild improvement in distal power, but he remained wheelchair bound and was transferred to a rehabilitation unit. Five months later, he started receiving panitumumab. After 5 weeks of treatment, he was able to walk without assistance. An 84-year-old man with metastatic colon cancer began receiving oxaliplatin, capecitabine, folinic acid and fluorouracil. After five cycles, chemotherapy was withheld due to diarrhoea and gram negative bacteraemia. His condition improved following treatment with antibiotics and supportive care. Three weeks later, he presented with a 2-day history of weakness in his arms and legs, shortness of breath, decreased reflexes and nasal speech. Nerve conduction studies were consistent with a sensory-motor polyneuropathy, and he was diagnosed with GBS. Despite treatment with immune globulin, his condition deteriorated and he developed dysphagia. Treatment with plasmapheresis led to an improvement in dysphagia and power. He was discharged home after 2 weeks of rehabilitation. Author comment: "[In the first case], GBS may have been a side effect of one of the medications (AMG 386, folinic acid, fluorouracil and irinotecan) that the patient had received most recently." "In the second case . . . oxaliplatin is a possible cause for these neurological findings." Vatandoust S, et al. Guillain-Barre syndrome in colorectal cancer. Asia-Pacific Journal of Clinical Oncology 8: 205-208, No. 2, Jun 2012. Available from: URL: http://dx.doi.org/10.1111/j.1743-7563.2011.01493.x - Australia 803073873 1 Reactions 21 Jul 2012 No. 1411 0114-9954/10/1411-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1411 - 21 Jul 2012
SAntineoplastics
Guillain-Barre syndrome?: 2 case reportsTwo patients developed Guillain-Barre syndrome (GBS)
while receiving chemotherapy for colorectal cancer [routes,dosages and durations of treatment to reactions onset notstated].
A 51-year-old man with stage III colon cancer beganreceiving trebananib [AMG 386] in combination withfolinic acid, fluorouracil and irinotecan (FOLFIRI). InSeptember 2009, after six cycles, trebananib wasdiscontinued due to peripheral oedema. He continued toreceive FOLFIRI until December 2009. The followingmonth, he presented with a few days’ history of weaknessand sensory loss in his forearms and legs. A lumbarpuncture revealed elevated protein and albumin-ocytological dissociation, and nerve conduction studieswere consistent with GBS. Treatment with immuneglobulin led to a mild improvement in distal power, but heremained wheelchair bound and was transferred to arehabilitation unit. Five months later, he started receivingpanitumumab. After 5 weeks of treatment, he was able towalk without assistance.
An 84-year-old man with metastatic colon cancer beganreceiving oxaliplatin, capecitabine, folinic acid andfluorouracil. After five cycles, chemotherapy was withhelddue to diarrhoea and gram negative bacteraemia. Hiscondition improved following treatment with antibioticsand supportive care. Three weeks later, he presented with a2-day history of weakness in his arms and legs, shortness ofbreath, decreased reflexes and nasal speech. Nerveconduction studies were consistent with a sensory-motorpolyneuropathy, and he was diagnosed with GBS. Despitetreatment with immune globulin, his condition deterioratedand he developed dysphagia. Treatment withplasmapheresis led to an improvement in dysphagia andpower. He was discharged home after 2 weeks ofrehabilitation.
Author comment: "[In the first case], GBS may have beena side effect of one of the medications (AMG 386, folinicacid, fluorouracil and irinotecan) that the patient had receivedmost recently.""In the second case . . . oxaliplatin is a possible cause forthese neurological findings."Vatandoust S, et al. Guillain-Barre syndrome in colorectal cancer. Asia-PacificJournal of Clinical Oncology 8: 205-208, No. 2, Jun 2012. Available from: URL:http://dx.doi.org/10.1111/j.1743-7563.2011.01493.x - Australia 803073873
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Reactions 21 Jul 2012 No. 14110114-9954/10/1411-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
