Bone marrow toxicity associated with 5-fluorocytosine therapy.
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 mug/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.
D000328:Adult; D000368:Aged; D001855:Bone Marrow Diseases / Q000139:chemically induced*; D003596:Cytosine / Q000031:analogs & derivatives*; D005260:Female; D005437:Flucytosine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007674:Kidney Diseases / Q000150:complications; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy
D003596:Cytosine; D005437:Flucytosine