Hypercalcemia and 13-cis-retinoic acid in post-consolidation therapy of neuroblastoma.
We report 19 episodes of hypercalcemia in three children treated with 13-cis-retinoic acid (13-cis-RA) as a post-consolidation therapy for high-risk neuroblastoma. There was no concomitant overload in 13-cis-RA blood levels. Blood calcium fell after arrest of 13-cis-RA intake. Half dosage retinoid treatment resumption did not prevent the recurrence of hypercalcemia. Concomitant biological values showed massive bone resorption. Hence, hypercalcemia seemed not secondary to 13-cis-RA overload but rather to inter-individual variability in its interaction with bone metabolism. Current guidelines in case of hypercalcemia are to reduce 13-cis-RA dosage. Instead we propose to maintain the therapeutic dosage, but to shorten the duration of courses.
Centre Léon Bérard, Institut d'Hématologie et d'Oncologie Pédiatrique, F-69008 Lyon, France. marabell@lyon.fnclcc.fr
Aurélien
A
Marabelle
Vincent
V
Sapin
Raphaël
R
Rousseau
Brigitte
B
Periquet
François
F
Demeocq
Justyna
J
Kanold
D001862:Bone Resorption / Q000139:chemically induced; D002118:Calcium / Q000097:blood; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced / Q000209:etiology*; D007223:Infant; D015474:Isotretinoin / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D008297:Male; D009447:Neuroblastoma / Q000150:complications* / Q000188:drug therapy*
D015474:Isotretinoin; D002118:Calcium