title: Myopericarditis caused by cyclophosphamide used to mobilize peripheral blood stem cells in a myeloma patient with renal failure.
abstract: Cyclophosphamide (CPA) is widely used for peripheral blood stem cell mobilization, and a dose adjustment of CPA in the presence of renal failure has not been suggested. However, we describe a myeloma patient with renal failure (serum creatinine 4.2 mg/dl, creatinine clearance 11.2 ml/min) receiving CPA 2 g/m2 for 2 days, who developed unexpectedly severe toxicity, including myopericarditis and prolonged myelosuppression. The serial serum concentrations of CPA metabolites were persistently much higher than those in a myeloma patient with normal renal function. We consider, therefore, that the dose of CPA should be reduced in the presence of severe renal failure when used as high-dose therapy or to mobilize peripheral blood stem cells.
authors.affiliation: Department of Hematology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Kanda
authors.forename: T
authors.initials: T
authors.lastname: Matsuyama
authors.forename: K
authors.initials: K
authors.lastname: Oshima
authors.forename: Y
authors.initials: Y
authors.lastname: Nannya
authors.forename: M
authors.initials: M
authors.lastname: Suguro
authors.forename: A
authors.initials: A
authors.lastname: Chizuka
authors.forename: T
authors.initials: T
authors.lastname: Hamaki
authors.forename: N
authors.initials: N
authors.lastname: Takezako
authors.forename: A
authors.initials: A
authors.lastname: Miwa
authors.forename: M
authors.initials: M
authors.lastname: Kami
authors.forename: S
authors.initials: S
authors.lastname: Mori
authors.forename: T
authors.initials: T
authors.lastname: Kojima
authors.forename: K
authors.initials: K
authors.lastname: Saito
authors.forename: Y
authors.initials: Y
authors.lastname: Itaoka
authors.forename: M
authors.initials: M
authors.lastname: Kashida
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects* / Q000097:blood / Q000493:pharmacokinetics; D003520:Cyclophosphamide / Q000009:adverse effects* / Q000493:pharmacokinetics; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D009101:Multiple Myeloma / Q000097:blood / Q000378:metabolism / Q000628:therapy; D009205:Myocarditis / Q000139:chemically induced*; D010490:Pericardial Effusion / Q000139:chemically induced; D010493:Pericarditis / Q000139:chemically induced*; D051437:Renal Insufficiency / Q000097:blood / Q000150:complications* / Q000378:metabolism
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide