Reactions 1473, p6-7 - 12 Oct 2013

SAntineoplastics

Bone marrow suppression in elderly patients:2 case reports

Two elderly men developed bone marrow suppressionduring chemotherapy with cyclophosphamide, vincristine,prednisone, doxorubicin, and etoposide for Langerhan’s cellhistiocytosis [routes not stated].

An elderly man [age at reaction onset not clearly stated]underwent chemotherapy with a 21-day cycle ofcyclophosphamide (750 mg/m2, d1), vincristine (1.4 mg/m2,d1), and prednisone (100 mg/m2, d1–5). He received sixcycles. After completion of his chemotherapy, he developedCTCAE grade IV bone marrow suppression. He was treatedwith a blood transfusion and G-CSF to increase his white bloodcell count. He had a relapse of Langerhan’s cell histiocytosisand received further chemotherapy with etoposide (100mg,d1–3), cyclophosphamide (750 mg/m2, d1), doxorubicin(50 mg/m2, d1), vincristine (1.4 mg/m2, d1), and prednisone(100mg, d1–5). He experienced grade IV bone marrowsuppression after one cycle. He underwent a blood transfusionand treatment to increase his white blood cell count. His totalsurvival period was 23 months [outcome of ADR not clearlystated].

A 66-year-old man underwent chemotherapy withcyclophosphamide, vincristine, and prednisone for four cycles[dosages not stated]. Partial remission was achieved and heunderwent radiotherapy. He underwent further chemotherapywith cyclophosphamide, vincristine, and prednisone anddeveloped grade IV bone marrow suppression after twocycles. He received a blood transfusion and treatment toincrease his white blood cell count. He gradually recovered.His total survival period was 26 months [outcome of ADR notclearly stated].

Author comment: The main side effect of radiotherapyand/or chemotherapy is bone marrow suppression after thetreatment.Zhang X, et al. Experience on the clinical features and treatment of elderlyLangerhans cell histiocytosis. Journal of Dalian Medical University 35: 163-166,No. 2, 2013. Available from: URL: http://dx.doi.org/10.11724/jdmu.2013.02.17[Chinese; summarised from a translation] - China 803093810

» Editorial comment: This paper included a third man withLangerhan’s cell histiocytosis but this patient did not receivechemotherapy.

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Reactions 12 Oct 2013 No. 14730114-9954/13/1473-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved