Antineoplastics

Antineoplastics Reactions 1680, p46 - 2 Dec 2017 Various toxicities: 2 case reports In a retrospective analytical study, two boys aged 3 years and 10 years were described, out of whom one boy developed fatal sepsis from a Gram negative bacterial infection during treatment with cisplatin, etoposide, cyclophosphamide, vincristine, carboplatin and ifosfamide, and the other boy developed pneumonia, sepsis, acute respiratory failure and multi-organ failure during treatment with cisplatin, etoposide, carboplatin, thiotepa, cyclophosphamide, ifosfamide, vincristine and melphalan [dosages, routes and times to reactions onsets not stated]. The 3-year-old boy was diagnosed with a stage M0 supratentorial atypical teratoid/rhabdoid tumour with somatic inactivation of SMARCB1/INI1 expression. He was started on the Korean Society for Paediatric Neuro-Oncology (KSPNO) S081 treatment protocol for the supratentorial atypical teratoid/rhabdoid tumour. Following a gross total resection surgery of the tumour, he received two cycles of conventional chemotherapy with alternating combination of regimen A consisting of cisplatin, etoposide, cyclophosphamide, and vincristine and regimen B comprising carboplatin, etoposide, ifosfamide and vincristine. Subsequently, he received craniospinal irradiation and radiotherapy. Post-radiotherapy, he again received four cycles of conventional chemotherapy with alternating combination of regimen A consisting of cisplatin, etoposide, cyclophosphamide, and vincristine, and regimen B comprising carboplatin, etoposide, ifosfamide and vincristine. However, during the post-radiotherapy chemotherapy, he died due to treatment related sepsis due to a Gram negative bacterial infection eight months following the diagnosis of his supratentorial atypical teratoid/rhabdoid tumour. The 10-year-old boy, who had a history of asthma was diagnosed with a stage M0 infratentorial atypical teratoid/ rhabdoid tumour with somatic inactivation of SMARCB1/INI1 expression. He was started on the Korean Society for Paediatric Neuro-Oncology (KSPNO) S1101 treatment protocol for the infratentorial atypical teratoid/rhabdoid tumour. Following a gross total resection surgery of the tumour, craniospinal irradiation and radiotherapy, he was received six cycles of conventional chemotherapy with alternating combination of regimen A consisting of cisplatin, etoposide, cyclophosphamide, and vincristine, and regimen B comprising carboplatin, etoposide, ifosfamide and vincristine. Thereafter, he received two cycles of high dose chemotherapy with cycle 1 comprising carboplatin, thiotepa and etoposide, and cycle 2 consisting of cyclophosphamide and melphalan. Along with the high dose chemotherapy, he also underwent a stem cell transplantation. However, he was hospitalised for severe dyspnoea and pneumonia. Subsequently, he developed sepsis, multi-organ failure and respiratory failure. At 16 months following the diagnosis of his infratentorial atypical teratoid/rhabdoid tumour he died due to pneumonia, sepsis, multi-organ failure and respiratory failure. Author comment: "Deaths were attributed to. . .treatment-related toxicity (n = 2) from sepsis and acute respiratory failure after [chemotherapy] and [high dose chemotherapy/stem cell transplantation]." "There were two deaths from toxicity in this study; one patient died from sepsis during conventional [chemotherapy] and another died from multiorgan failure with pneumonia and sepsis after completing [high dose chemotherapy/stem cell transplantation]." Lee J, et al. Atypical teratoid/rhabdoid tumors in children treated with multimodal therapies: The necessity of upfront radiotherapy after surgery. Pediatric Blood and Cancer 64: e26663, No. 12, Dec 2017. Available from: URL: http:// doi.org/10.1002/pbc.26663 - South Korea 803284445 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Antineoplastics

Reactions Weekly , Volume 1680 (1) – Dec 2, 2017
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Publisher
Springer Journals
Copyright
Copyright © 2017 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-017-38977-2
Publisher site
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Abstract

Reactions 1680, p46 - 2 Dec 2017 Various toxicities: 2 case reports In a retrospective analytical study, two boys aged 3 years and 10 years were described, out of whom one boy developed fatal sepsis from a Gram negative bacterial infection during treatment with cisplatin, etoposide, cyclophosphamide, vincristine, carboplatin and ifosfamide, and the other boy developed pneumonia, sepsis, acute respiratory failure and multi-organ failure during treatment with cisplatin, etoposide, carboplatin, thiotepa, cyclophosphamide, ifosfamide, vincristine and melphalan [dosages, routes and times to reactions onsets not stated]. The 3-year-old boy was diagnosed with a stage M0 supratentorial atypical teratoid/rhabdoid tumour with somatic inactivation of SMARCB1/INI1 expression. He was started on the Korean Society for Paediatric Neuro-Oncology (KSPNO) S081 treatment protocol for the supratentorial atypical teratoid/rhabdoid tumour. Following a gross total resection surgery of the tumour, he received two cycles of conventional chemotherapy with alternating combination of regimen A consisting of cisplatin, etoposide, cyclophosphamide, and vincristine and regimen B comprising carboplatin, etoposide, ifosfamide and vincristine. Subsequently, he received craniospinal irradiation and radiotherapy. Post-radiotherapy, he again received four cycles of conventional chemotherapy with alternating combination of regimen A consisting of cisplatin, etoposide, cyclophosphamide, and vincristine, and regimen B comprising carboplatin, etoposide, ifosfamide and vincristine. However, during the post-radiotherapy chemotherapy, he died due to treatment related sepsis due to a Gram negative bacterial infection eight months following the diagnosis of his supratentorial atypical teratoid/rhabdoid tumour. The 10-year-old boy, who had a history of asthma was diagnosed with a stage M0 infratentorial atypical teratoid/ rhabdoid tumour with somatic inactivation of SMARCB1/INI1 expression. He was started on the Korean Society for Paediatric Neuro-Oncology (KSPNO) S1101 treatment protocol for the infratentorial atypical teratoid/rhabdoid tumour. Following a gross total resection surgery of the tumour, craniospinal irradiation and radiotherapy, he was received six cycles of conventional chemotherapy with alternating combination of regimen A consisting of cisplatin, etoposide, cyclophosphamide, and vincristine, and regimen B comprising carboplatin, etoposide, ifosfamide and vincristine. Thereafter, he received two cycles of high dose chemotherapy with cycle 1 comprising carboplatin, thiotepa and etoposide, and cycle 2 consisting of cyclophosphamide and melphalan. Along with the high dose chemotherapy, he also underwent a stem cell transplantation. However, he was hospitalised for severe dyspnoea and pneumonia. Subsequently, he developed sepsis, multi-organ failure and respiratory failure. At 16 months following the diagnosis of his infratentorial atypical teratoid/rhabdoid tumour he died due to pneumonia, sepsis, multi-organ failure and respiratory failure. Author comment: "Deaths were attributed to. . .treatment-related toxicity (n = 2) from sepsis and acute respiratory failure after [chemotherapy] and [high dose chemotherapy/stem cell transplantation]." "There were two deaths from toxicity in this study; one patient died from sepsis during conventional [chemotherapy] and another died from multiorgan failure with pneumonia and sepsis after completing [high dose chemotherapy/stem cell transplantation]." Lee J, et al. Atypical teratoid/rhabdoid tumors in children treated with multimodal therapies: The necessity of upfront radiotherapy after surgery. Pediatric Blood and Cancer 64: e26663, No. 12, Dec 2017. Available from: URL: http:// doi.org/10.1002/pbc.26663 - South Korea 803284445 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680

Journal

Reactions WeeklySpringer Journals

Published: Dec 2, 2017

References

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