Open AccessBone Marrow Toxicity Associated with 5-Fluorocytosine Therapy
Author(s) -
Carol A. Kauffman,
Peter T. Frame
Publication year - 1977
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.11.2.244
Subject(s) - toxicity , leukopenia , bone marrow , medicine , sepsis , aplasia , renal function , flucytosine , bone marrow suppression , amphotericin b , pharmacology , gastroenterology , immunology , antifungal , dermatology
Bone marrow toxicity occurred in 4 of 15 patients treated with 5-fluorocytosine (5-FC) for serious fungal infections. The development of marrow toxicity appeared to be related to serum 5-FC levels of 125 μg/ml or greater. In three patients, accumulation of toxic levels of 5-FC was related to diminished renal function. One patient with acute renal failure and prolonged high levels of 5-FC developed marrow aplasia and died of bacterial sepsis. Three patients experienced leukopenia, which was readily reversed when the dosage of 5-FC was decreased and the serum concentration was lowered. With careful monitoring of serum 5-FC concentration and renal function, the dose-related toxic effects of 5-FC on the marrow can be avoided.