Fatal peripheral neuropathy following FLA chemotherapy.
We discuss a case with significant progressive peripheral neurological deterioration following administration of both fludarabine and cytarabine as part of the FLA (fludarabine and cytarabine) regime. Of particular interest is that toxicity only occurred during the second course of FLA and sixth course of Ara-C containing chemotherapy. At this point, a new antifungal agent had been commenced, suggesting a possible drug interaction enhancing the risk of known neurological toxicity with this regime.
Osborne
W L
WL
Bone Marrow Transplant Unit and Department of Haematology, Glasgow Royal Infirmary, Glasgow, UK.
Holyoake
T L
TL
McQuaker
I G
IG
Parker
A N
AN
D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D004347:Drug Interactions; D017809:Fatal Outcome; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy; D008172:Lung Diseases, Fungal / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000175:diagnosis; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D003561:Cytarabine; D014740:Vidarabine; D065819:Voriconazole; C024352:fludarabine