Reactions 1333 - 8 Jan 2011

SAntineoplastics

Acute renal failure associated with BKVreactivation: case report

A man developed acute renal failure due to polyoma BKvirus reactivation following multiple chemotherapytreatments for refractory T-cell lymphoma [time to reactiononset not clearly stated].

The man, who was diagnosed with peripheral T-celllymphoma at the age of 55 years, received three courses ofcyclophosphamide, vincristine, doxorubicin anddexamethasone (hyper-CVAD) with high-dosemethotrexate and cytarabine. Due to a lack of durableresponse, he underwent salvage chemotherapy, receiving acycle each of etoposide, vincristine, doxorubicin,prednisolone and cyclophosphamide (EPOCH),dexamethasone, etoposide, ifosfamide and carboplatin(DeVIC) and gemcitabine, dexamethasone and cisplatin(GDP) [dosages and routes not stated]; however, hisdisease continued to progress. Eight months afterdiagnosis, he developed fever and dyspnoea. Investigationsrevealed systemic complications of lymphoma and hereceived palliative chemotherapy with irinotecan30 mg/m2/day on days 1-3 and dexamethasone 10 mg/dayon days 4-6 [routes not stated], which relieved hisdyspnoea. Ten days after starting this regimen, hedeveloped urinary frequency and fever. He became anuric5 days later, and his serum creatinine rose to 3.3 mg/dL.Tests led to a diagnosis of nephropathy associated with thereactivation of a polyoma (BK) virus infection.

The man was started on haemodialysis 17 days afterinitiating chemotherapy, with a peak creatinine level of7.2 mg/dL. He died of disease progression 3 monthsfollowing diagnosis of acute renal failure. His family did notconsent to an autopsy.Aoki K, et al. Acute renal failure associated with systemic polyoma BK virusactivation in a patient with peripheral T-cell lymphoma. International Journal ofHematology 92: 638-641, No. 4, Nov 2010. Available from: URL: http://dx.doi.org/10.1007/s12185-010-0694-6 - Japan 803047215

1

Reactions 8 Jan 2011 No. 13330114-9954/10/1333-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved