Nitroso-urea–cisplatin-based chemotherapy associated with valproate: Increase of haematologic toxicity
| Autor: | Véronique Bourg, Christine Lebrun, Pierre Thomas, R. M. Chichmanian, Marc Frenay |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Phenytoin medicine.medical_specialty Neutropenia medicine.medical_treatment Gastroenterology Nitrosourea Compounds Organophosphorus Compounds Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Drug Interactions Aged Etoposide Retrospective Studies Chemotherapy Epilepsy Hematologic Tests Brain Neoplasms business.industry Valproic Acid Glioma Hematology Carbamazepine Middle Aged medicine.disease Thrombocytopenia Chemotherapy regimen Regimen Anticonvulsant Oncology Anesthesia Fotemustine Anticonvulsants Female Cisplatin business medicine.drug |
| Zdroj: | Annals of Oncology. 12:217-220 |
| ISSN: | 0923-7534 |
| DOI: | 10.1023/a:1008331708395 |
| Popis: | Summary Background The incidence of haematologic toxicity of valproate (VPA) ranges from 1% to 32%, and consists mainly of asymptomatic, dose-dependent thrombopenia. We describe a potentiation of haematologic side-effects of nitroso-urea (NU) when prescribed in association with VPA. Patients and methods We followed a cohort of 70 patients (58 men, 22 women, mean age: 56 years, range 20–75 years). Patients with high-grade gliomas were treated with up-front chemotherapy regimen consisting of fotemustine (d3: 100 mg/m2), cisplatin (dl–3: 33 mg/m2) and etoposide (dl–3: 75 mg/m2) followed by whole brain radiotherapy at progression. Sixty patients required anti-epileptic drugs (AED) for either a single, well-documented epileptic seizure, or immediatly initiated after neurosurgical procedures. AED included VPA (35 of 60), phenobarbital (PB) (17 of 60), carbamazepine (CBZ) (2 of 60) and phenytoin (PHT) (3 of 60). Two patients had both PB and CBZ and one PB and PHT. Results Haematologic toxicity (grade 3–4 thrombopenia, neutropenia or both) was observed in 37 of 70 (52.85%) patients. Among them 24 (65%) had VPA. Group C were patients treated with fotemustine alone with or without VPA (23 patients). Conclusion When prescribed in association with a fotemustine-cisplatin regimen, VPA treatment results in a three-fold higher incidence of reversible thrombopenia, neutropenia or both. Haematologic side-effects decrease after AED modification during the continued chemotherapy. This adverse event should be managed with caution. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|