Antineoplastics
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Reactions 1429 - 24 Nov 2012 S Antineoplastics Latent tuberculosis reactivation in an elderly patient: case report A 67-year-old man with stage III Hodgkin’s disease developed latent tuberculosis reactivation following multiple cycles of various antineoplastic regimens [dosages and routes not stated]. The man initially presented 4 years prior with an adenocarcinoma of the left colon. He achieved complete remission following treatment with hemicolectomy, lymphadenectomy and 12 cycles of adjuvant chemotherapy comprising irinotecan, fluorouracil and folinic acid. Two years later, he was diagnosed with an isolated carcinoid of the lung. Despite 6 cycles of chemotherapy comprising doxorubicin, bleomycin, vinblastine and dacarbazine, his disease progressed. A salvage chemotherapy regimen comprising dexamethasone, cisplatin and cytarabine was initiated. Between the first and second cycles of salvage chemotherapy, he presented with a hard nodule in the left testis and urine culture identified Mycobacterium tuberculosis complex. A 6-month course of antitubercular therapy was initiated. After 2 months of treatment, the man’s urine culture for M. tuberculosis was negative. Antitubercular therapy was continued during administration of a high-dose chemotherapy conditioning regimen comprising carmustine, cytarabine, etoposide and melphalan prior to autologous peripheral blood stem cell transplant. Repeat urine cultures for M. tuberculosis during transplantation as well as 2 and 4 months post-transplant were negative. At last observation 2 years post-transplant, his urine cultures remained negative. Author comment: "A condition of immune-suppression caused by a malignancy, the prolonged chemotherapy treatments, and advanced age may favor TB reactivation." Zanet E, et al. Mycobacterium tuberculosis: An infection we should suspect in bone marrow transplantation. Journal of Chemotherapy 23: 312-313, No. 5, Oct 2011 - Italy 803080100 1 Reactions 24 Nov 2012 No. 1429 0114-9954/10/1429-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1429 - 24 Nov 2012
SAntineoplastics
Latent tuberculosis reactivation in an elderlypatient: case report
A 67-year-old man with stage III Hodgkin’s diseasedeveloped latent tuberculosis reactivation followingmultiple cycles of various antineoplastic regimens [dosagesand routes not stated].
The man initially presented 4 years prior with anadenocarcinoma of the left colon. He achieved completeremission following treatment with hemicolectomy,lymphadenectomy and 12 cycles of adjuvantchemotherapy comprising irinotecan, fluorouracil andfolinic acid. Two years later, he was diagnosed with anisolated carcinoid of the lung. Despite 6 cycles ofchemotherapy comprising doxorubicin, bleomycin,vinblastine and dacarbazine, his disease progressed. Asalvage chemotherapy regimen comprisingdexamethasone, cisplatin and cytarabine was initiated.Between the first and second cycles of salvagechemotherapy, he presented with a hard nodule in the lefttestis and urine culture identified Mycobacteriumtuberculosis complex.
A 6-month course of antitubercular therapy was initiated.After 2 months of treatment, the man’s urine culture for M.tuberculosis was negative. Antitubercular therapy wascontinued during administration of a high-dosechemotherapy conditioning regimen comprisingcarmustine, cytarabine, etoposide and melphalan prior toautologous peripheral blood stem cell transplant. Repeaturine cultures for M. tuberculosis during transplantation aswell as 2 and 4 months post-transplant were negative. Atlast observation 2 years post-transplant, his urine culturesremained negative.
Author comment: "A condition of immune-suppressioncaused by a malignancy, the prolonged chemotherapytreatments, and advanced age may favor TB reactivation."Zanet E, et al. Mycobacterium tuberculosis: An infection we should suspect inbone marrow transplantation. Journal of Chemotherapy 23: 312-313, No. 5, Oct2011 - Italy 803080100
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Reactions 24 Nov 2012 No. 14290114-9954/10/1429-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
