Recognition and management of methemoglobinemia and hemolysis in a G6PD-deficient patient on experimental anticancer drug Triapine.
We report occurrence of severe methemoglobinemia in a patient on novel experimental anti-cancer drug, Triapine. Treatment with methylene blue led to massive hemolysis due to concomitant G6PD deficiency. We recommend that G6PD screening be done in high-risk populations prior to commencement of Triapine therapy.
Division of Hematology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Lynda M
LM
Foltz
Bakul I
BI
Dalal
Louis D
LD
Wadsworth
Raewyn
R
Broady
Kim
K
Chi
Elizabeth
E
Eisenhauer
Ken
K
Kobayashi
Christian
C
Kollmannsburger
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000188:drug therapy; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications*; D006461:Hemolysis / Q000187:drug effects*; D006801:Humans; D008708:Methemoglobinemia / Q000139:chemically induced*; D008875:Middle Aged; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects*; D013882:Thiosemicarbazones / Q000008:administration & dosage / Q000009:adverse effects*
D000970:Antineoplastic Agents; D011725:Pyridines; D013882:Thiosemicarbazones; C078157:3-aminopyridine-2-carboxaldehyde thiosemicarbazone