title: A case of vinblastine overdose managed with plasma exchange.
abstract: Severe, life-threatening toxicity may be caused by errors in chemotherapy administration. To contribute with some useful information on drug-induced toxic effects and salvage therapy, we report a case of vinblastine (VBL) overdose (25 mg/m(2)) in a 12-year-old child affected by an end-stage metastatic primitive neuroectodermal tumor. Early signs of toxicity were acute, severe musculoskeletal pain and fever. This was followed by intestinal hypotonia, severe esophagitis, and peripheral neuropathy. Two consecutive plasma exchange procedures were performed at 4 and 18 hr after the administration of the overdose of VBL. The overall toxicity this child experienced was much less severe than expected; this finding, in combination with the known pharmacokinectis data of VBL in children, made us hypothesize that plasma exchange might have had a role in lowering the side effects of drug over dosage.
authors.affiliation: Division of Hematology/Oncology, Department of Pediatrics, Padua University Hospital, Via Giustiniani 3, 35128 Padua, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Spiller
authors.forename: Piero
authors.initials: P
authors.lastname: Marson
authors.forename: Giorgio
authors.initials: G
authors.lastname: Perilongo
authors.forename: Maria
authors.initials: M
authors.lastname: Farina
authors.forename: Modesto
authors.initials: M
authors.lastname: Carli
authors.forename: Gianni
authors.initials: G
authors.lastname: Bisogno
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000506:poisoning*; D002648:Child; D062787:Drug Overdose / Q000628:therapy; D006801:Humans; D008297:Male; D010951:Plasma Exchange; D014747:Vinblastine / Q000506:poisoning*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014747:Vinblastine