Premium
Creatine kinase elevation associated with 5‐fluorouracil and levamisole therapy for carcinoma of the colon: A case report
Author(s) -
Cersosimo Robert J.,
Lee JeongMin
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960401)77:7<1250::aid-cncr4>3.0.co;2-m
Subject(s) - medicine , levamisole , chemotherapy , creatine kinase , fluorouracil , discontinuation , colorectal cancer , gastroenterology , surgery , cancer
BACKGROUND There have been no reports of creatine phosphokinase (CK) elevation during levamisole administration. There is only one prior report of CK elevation of noncardiac origin associated with 5‐fluorouracil. METHODS A 41‐year‐old man was diagnosed with Stage B2 colon carcinoma and underwent extensive surgical resection. Adjuvant therapy with 5‐fluorouracil and levamisole was initiated after surgery. A complete hematologic and chemistry profile was obtained during weekly clinic visits. RESULTS The patient's serum CK levels were normal prior to the initiation of chemotherapy but began to rise after 4 weeks of therapy. Isoenzyme analysis revealed that the CK was 100% from skeletal muscle. When the CK level surpassed 1,000 U/L, chemotherapy was discontinued. The CK levels began to decline immediately, falling to normal within 2 months. All attempts to identify a known cause of the enzyme elevation were negative. CONCLUSIONS The temporal relationship between chemotherapy administration, enzyme elevation, and the rapid fall in enzyme levels upon discontinuation of treatment argue strongly in favor of chemotherapy as the etiology of CK elevation in this patient. Cancer 1996;77:1250‐3.