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Potentiation of vincristine toxicity by itraconazole in children with lymphoid malignancies
Author(s) -
Kamaluddin M,
McNally P,
Breatnach F,
O'Marcaigh A,
Webb D,
O'Dell E,
Scanlon P,
Butler K,
O'Meara A
Publication year - 2001
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2001.tb03257.x
Subject(s) - medicine , vincristine , itraconazole , perforation , adverse effect , ileus , anesthesia , gastroenterology , surgery , chemotherapy , cyclophosphamide , dermatology , antifungal , materials science , punching , metallurgy
Eight consecutive paediatric patients with acute lymphoblastic leukaemia (ALL) ( n =7) and T‐cell non‐Hodgkin's lymphoma (NHL) ( n =1) presenting within a 5‐wk interval were started on a standard induction protocol which included weekly treatment with vincristine for 4 wk. Itraconazole was commenced as antifungal prophylaxis, 1–21 d after the first injection of vincristine. Within 2 to 4 wk, enhanced vincristine neurotoxicity was noted in all patients, abdominal cramps and constipation occurred most frequently, and one patient developed a bowel perforation associated with paralytic ileus. Hyponatraemia associated with SIADH was observed in three patients and four patients developed seizures. An additional patient with B cell NHL developed seizures 5 d after an injection of vincristine. Recovery was complete in all patients and ranged from 2 d to 15 wk. Conclusion : The extent and consistency of adverse effects documented in this study support the recommendation that concurrent administration of vincristine and itraconazole should be avoided.