Brincidofovir (CMX001) Toxicity Associated With Epithelial Apoptosis and Crypt Drop Out in a Hematopoietic Cell Transplant Patient: Challenges in Distinguishing Drug Toxicity From GVHD
| Autor: | Sarah B. Mueller, Claire J. Detweiler, Anthony D. Sung, Vinod K. Prasad, Jennifer L. Saullo, Diana M. Cardona |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Colon Adenoviridae Infections medicine.medical_treatment 030106 microbiology Organophosphonates Graft vs Host Disease Octreotide Brincidofovir Hematopoietic stem cell transplantation Gastroenterology Article Adenoviridae Cytosine 03 medical and health sciences chemistry.chemical_compound Internal medicine medicine Humans Viremia Autografts business.industry Hematopoietic Stem Cell Transplantation Hematology medicine.disease Hematochezia Transplantation Graft-versus-host disease Oncology chemistry Child Preschool Pediatrics Perinatology and Child Health Toxicity medicine.symptom business Medulloblastoma Cidofovir medicine.drug |
| Zdroj: | Journal of Pediatric Hematology/Oncology. 40:e364-e368 |
| ISSN: | 1077-4114 |
| DOI: | 10.1097/mph.0000000000001227 |
| Popis: | Brincidofovir (CMX001) is an oral agent with activity against double-strand DNA viruses undergoing clinical trials in immunocompromised patients. We report a patient clinically diagnosed with brincidofovir-related gastrointestinal (GI) toxicity and his histologic findings. A 2-year-old boy with medulloblastoma undergoing autologous hematopoietic cell transplantation developed adenovirus viremia 9 days posttransplant. After initial treatment with intravenous cidofovir he was started on oral brincidofovir as part of a clinical trial. He developed hematochezia, anorexia, and emesis 11 weeks later. Sigmoid colon biopsy showed marked crypt drop out, moderate epithelial apoptosis, and lamina propria edema. The pathologic diagnosis was drug-related injury versus infection. Brincidofovir toxicity was diagnosed clinically and the drug was discontinued. His GI symptoms improved in 2 weeks with supportive care and octreotide. Brincidofovir causes GI toxicity and histologically demonstrates epithelial apoptosis and crypt injury, similar to graft versus host disease and mycophenolate mofetil toxicity. |
| Databáze: | OpenAIRE |
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