Antineoplastics/tacrolimus
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Reactions 1500, p9-10 - 10 May 2014 S Antineoplastics/tacrolimus T-cell acute lymphoblastic leukaemia and fatal chemotherapy-induced sepsis: case report A 5-year-old boy developed T-cell acute lymphoblastic leukaemia during treatment with tacrolimus and prednisolone and later died because of chemotherapy-induced sepsis after treatment with prednisolone, vincristine, etoposide, doxorubicin [adriamycin], cyclophosphamide, and methotrexate. The boy had a liver transplant at the age of 3 years due to hepatoblastoma, and was started on immunosuppressive therapy with tacrolimus and prednisolone [dosages and routes not stated]. At the age of 5 years he presented with severe cough. A CT scan of chest revealed a large left mediastinal mass and left pleural effusion. Tru-Cut needle biopsy report revealed diffuse infiltration with blast cells. The boy was diagnosed with T-cell acute lymphoblastic leukaemia (T-ALL). Strong and diffuse terminal deoxynucleotidyl transferase and CD3 antibody expression was observed in immunohistochemical examination of the blasts. The Ki-67 proliferation index was > 95%, and tumour cells were negative for Epstein-Barr virus. Cytopathological examination of pleural fluid showed no leukaemia. The boy’s tacrolimus was switched to sirolimus and a chemotherapy regimen consisting of prednisolone, vincristine, etoposide, doxorubicin, cyclophosphamide [dosages and routes not stated], and intrathecal methotrexate [dosage not stated] was started. The boy died 2 months after the diagnosis, due to chemotherapy-induced sepsis. Author comment: "Tacrolimus was stopped, sirolimus was started, and chemotherapy was given, but he died 2 months after diagnosis because of chemotherapy-induced sepsis." "Immunosuppressive therapy may be a possible risk factor for the development of T-ALL." Ozkan EA, et al. T-cell acute lymphoblastic leukemia after liver transplant. Experimental and Clinical Transplantation 12: 139-141, No. 1, Mar 2014 - Turkey 803102872 1 Reactions 10 May 2014 No. 1500 0114-9954/14/1500-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics/tacrolimus
Reactions 1500, p9-10 - 10 May 2014
SAntineoplastics/tacrolimus
T-cell acute lymphoblastic leukaemia and fatalchemotherapy-induced sepsis: case report
A 5-year-old boy developed T-cell acute lymphoblasticleukaemia during treatment with tacrolimus and prednisoloneand later died because of chemotherapy-induced sepsis aftertreatment with prednisolone, vincristine, etoposide,doxorubicin [adriamycin], cyclophosphamide, andmethotrexate.
The boy had a liver transplant at the age of 3 years due tohepatoblastoma, and was started on immunosuppressivetherapy with tacrolimus and prednisolone [dosages and routesnot stated]. At the age of 5 years he presented with severecough. A CT scan of chest revealed a large left mediastinalmass and left pleural effusion. Tru-Cut needle biopsy reportrevealed diffuse infiltration with blast cells. The boy wasdiagnosed with T-cell acute lymphoblastic leukaemia (T-ALL).Strong and diffuse terminal deoxynucleotidyl transferase andCD3 antibody expression was observed inimmunohistochemical examination of the blasts. The Ki-67proliferation index was > 95%, and tumour cells were negativefor Epstein-Barr virus. Cytopathological examination of pleuralfluid showed no leukaemia.
The boy’s tacrolimus was switched to sirolimus and achemotherapy regimen consisting of prednisolone, vincristine,etoposide, doxorubicin, cyclophosphamide [dosages androutes not stated], and intrathecal methotrexate [dosage notstated] was started. The boy died 2 months after the diagnosis,due to chemotherapy-induced sepsis.
Author comment: "Tacrolimus was stopped, sirolimus wasstarted, and chemotherapy was given, but he died 2 monthsafter diagnosis because of chemotherapy-induced sepsis.""Immunosuppressive therapy may be a possible risk factor forthe development of T-ALL."Ozkan EA, et al. T-cell acute lymphoblastic leukemia after liver transplant.Experimental and Clinical Transplantation 12: 139-141, No. 1, Mar 2014 -Turkey 803102872
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Reactions 10 May 2014 No. 15000114-9954/14/1500-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
