Antineoplastics
1
Reactions 1398 - 21 Apr 2012 S Antineoplastics Herpes simplex encephalitis: 7 case reports Seven cancer patients were identified from a retrospective study [see table] after they developed herpes simplex encephalitis (HSE) following treatment with antineoplastics [routes and durations of treatment to reaction onsets not stated]. Six patients later died. Patient characteristics Patient/sex/ Indication Suspect drugs (dose) age (y) 1/F/67 primary CNS rituximab, methotrexate, lymphoma vincristine, procarbazine 2/F/48 metastatic non-small pemetrexed, cell lung cancer dexamethasone (6mg) 3/M/55 metastatic melanoma dexamethasone (12mg) 4/F/54 metastatic breast gemcitabine, trastuzumab cancer 5/F/76 breast cancer capecitabine 6/F/45 thyroid cancer dexamethasone (8mg) 7/M/69 metastatic renal cell sunitinib, gefitinib cancer Three of the patients were receiving dexamethasone at the onset of HSE [frequencies not stated], while five patients had received other antineoplastics within the past 3 months [dosages not stated]. Patients 2–4 and 7 had also received whole brain radiotherapy. MRI findings for all patients were consistent with temporal lobe encephalitis. In four patients, herpes simplex virus (HSV) type 1 was identified by CSF PCR analysis, while two patients were positive for HSV-2. The remaining man (patient 7) was negative for HSV by CSF PCR; however, autopsy confirmed active HSV. MRI findings for patient 6 were also suggestive of HSV-induced cerebral vasculitis. Additionally, this patient had developed HSV-positive skin lesions. All patients received aciclovir therapy; however, patients 1, 3, 4, 6 and 7 did not significantly improve, and died 7–74 days after presentation. Patient 5 recovered with some residual deficits; however, she later died from her breast cancer. The remaining woman (patient 2) was transferred to a hospice due to her worsening condition, and was subsequently lost to follow-up. Graber JJ, et al. Herpes simplex encephalitis in patients with cancer. Journal of Neuro-Oncology 105: 415-21, No. 2, Nov 2011 - USA 803069329 1 Reactions 21 Apr 2012 No. 1398 0114-9954/10/1398-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
-
Upload
phamnguyet -
Category
Documents
-
view
213 -
download
1
Transcript of Antineoplastics
Reactions 1398 - 21 Apr 2012
SAntineoplastics
Herpes simplex encephalitis: 7 case reportsSeven cancer patients were identified from a
retrospective study [see table] after they developed herpessimplex encephalitis (HSE) following treatment withantineoplastics [routes and durations of treatment toreaction onsets not stated]. Six patients later died.
Patient characteristicsPatient/sex/ Indication Suspect drugs (dose)age (y)
1/F/67 primary CNS rituximab, methotrexate,lymphoma vincristine, procarbazine
2/F/48 metastatic non-small pemetrexed,cell lung cancer dexamethasone (6mg)
3/M/55 metastatic melanoma dexamethasone (12mg)4/F/54 metastatic breast gemcitabine, trastuzumab
cancer5/F/76 breast cancer capecitabine6/F/45 thyroid cancer dexamethasone (8mg)7/M/69 metastatic renal cell sunitinib, gefitinib
cancer
Three of the patients were receiving dexamethasone atthe onset of HSE [frequencies not stated], while fivepatients had received other antineoplastics within the past3 months [dosages not stated]. Patients 2–4 and 7 had alsoreceived whole brain radiotherapy. MRI findings for allpatients were consistent with temporal lobe encephalitis.In four patients, herpes simplex virus (HSV) type 1 wasidentified by CSF PCR analysis, while two patients werepositive for HSV-2. The remaining man (patient 7) wasnegative for HSV by CSF PCR; however, autopsy confirmedactive HSV. MRI findings for patient 6 were also suggestiveof HSV-induced cerebral vasculitis. Additionally, thispatient had developed HSV-positive skin lesions.
All patients received aciclovir therapy; however,patients 1, 3, 4, 6 and 7 did not significantly improve, anddied 7–74 days after presentation. Patient 5 recovered withsome residual deficits; however, she later died from herbreast cancer. The remaining woman (patient 2) wastransferred to a hospice due to her worsening condition,and was subsequently lost to follow-up.Graber JJ, et al. Herpes simplex encephalitis in patients with cancer. Journal ofNeuro-Oncology 105: 415-21, No. 2, Nov 2011 - USA 803069329
1
Reactions 21 Apr 2012 No. 13980114-9954/10/1398-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
