Reactions 1365 - 20 Aug 2011

SAntineoplastics

Various toxicities: 4 case reportsFour patients developed various toxicities following high-

dose chemotherapy with autologous stem cell transplant(ASCT) for Hodgkin’s lymphoma.

A 38-year-old woman received oral busulfan 1 mg/kg andIV cyclophosphamide 60 mg/day on day –3 and –2 prior toASCT. Thirteen days following ASCT, she developedhepatic veno-occlusive disease. She was admitted to theICU with multiple organ failure and received defibrotide.Her condition improved and she was discharged.

A 62-year-old woman received IV cyclophosphamide60 mg/day on day –3 and –2 prior to ASCT in addition tobusulfan. She subsequently developed transient congestiveheart failure [time to reaction onset not stated]. This waspostulated to be due to cyclophosphamide cardiotoxicity.Her heart failure was medical managed, and her cardiacfunction returned to baseline.

A 39-year-old woman, who had been receivingphenytoin for a seizure disorder, received oral busulfan1 mg/kg in addition to cyclophosphamide on day –3 and –2prior to ASCT. She experienced a generalized tonic–clonicseizure on her third day of conditioning treatment. Her finaltwo doses of busulfan were withheld, and she did notexperience any further seizures.

A 23-year-old man, who had been previously treatedwith doxorubicin, bleomycin, vinblastine, dacarbazine(ABVD) and ifosfamide, carboplatin, etoposide (ICE)chemotherapy [dosages and routes not stated] forHodgkin’s lymphoma, underwent ASCT. Testing prior to anautologous stem cell transplant revealed asymptomaticinterstitial lung disease possibly related to priorchemotherapy. Fifty-seven days after ASCT, he presentedwith severe shortness of breath and hypoxemia. He wasintubated and placed on a ventilator. Lung wedge biopsyshowed diffuse alveolar damage and early fibrosis.However, he died 88 days post-transplant due topneumonitis-related complications, despite high-dosesteroid treatment.Lane AA, et al. High-dose chemotherapy with busulfan and cyclophosphamide andautologous stem cell rescue in patients with Hodgkin lymphoma. Leukemia andLymphoma 52: 1363-1366, No. 7, Jul 2011. Available from: URL: http://dx.doi.org/10.3109/10428194.2011.572324 - USA 803058854

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Reactions 20 Aug 2011 No. 13650114-9954/10/1365-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved