Aminoglycoside-induced deafness during treatment of acute leukaemia.
Three unrelated children from ethnically diverse backgrounds who were treated for acute leukaemia became profoundly and irreversibly deaf during treatment. Aminoglycoside levels were within the therapeutic range. Genetic testing showed all three to have a maternally inherited mutation of mitochondrial DNA, m.1555A>G, known to cause sensitivity to the ototoxic effects of aminoglycosides. One child has received a cochlear implant, and another will be implanted shortly. Children diagnosed with acute leukaemia should be tested for this mutation at diagnosis, and alternative antibiotics chosen for the treatment of sepsis. Consideration should be given to elective testing of other groups of patients likely to receive aminoglycosides.
Bitner-Glindzicz
M
M
Clinical and Molecular Genetics Unit, UCL Institute of Child Health and Great Ormond Street Hospital NHS Trust, 30 Guilford St, London WC1N 1EH, UK. mbitnerg@ich.ucl.ac.uk
Osei-Lah
V
V
Colvin
I
I
Sirimanna
T
T
Lucas
D
D
Mac Ardle
B
B
Webb
D
D
Shankar
A
A
Kingston
J
J
Jenkins
L
L
Rahman
S
S
D000617:Aminoglycosides / Q000009:adverse effects* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D004272:DNA, Mitochondrial / Q000235:genetics; D003638:Deafness / Q000139:chemically induced* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D009154:Mutation; D009894:Opportunistic Infections / Q000188:drug therapy; D010375:Pedigree; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D004272:DNA, Mitochondrial