K C Trent1, L Myers, J Moreb. 1. Department of Medicine, University of Florida, Gainesville 32610, USA.
Abstract
OBJECTIVE: To report a lomustine overdose in a patient with anaplastic astrocytoma. CASE SUMMARY: A 28-year-old woman with anaplastic astrocytoma was treated with partial resection and radiation therapy followed by a lomustine-containing regimen. The patient took lomustine 1400 mg po over a week, her regular dose being 200 mg on day 1 of the regimen. Pancytopenia developed within a week after the last dose of lomustine and the patient was admitted to the bone marrow transplant unit for supportive care. About 3 weeks later, the patient gradually developed a multiorgan dysfunction, including liver, brain, and lungs without evidence of infection or tumor progression, and died on day 45 of hospitalization. DISCUSSION: This is the third reported case of lomustine overdose that resulted from supplying the patient with more tablets than needed for 1 dose. Although late hematopoietic recovery may be possible after such a high dose of lomustine, other organ toxicities might be detrimental. CONCLUSIONS: Physicians and pharmacists should avoid supplying more tablets than needed for 1 lomustine dose. High doses of lomustine may cause irreversible multiorgan toxicities.
OBJECTIVE: To report a lomustineoverdose in a patient with anaplastic astrocytoma. CASE SUMMARY: A 28-year-old woman with anaplastic astrocytoma was treated with partial resection and radiation therapy followed by a lomustine-containing regimen. The patient took lomustine 1400 mg po over a week, her regular dose being 200 mg on day 1 of the regimen. Pancytopenia developed within a week after the last dose of lomustine and the patient was admitted to the bone marrow transplant unit for supportive care. About 3 weeks later, the patient gradually developed a multiorgan dysfunction, including liver, brain, and lungs without evidence of infection or tumor progression, and died on day 45 of hospitalization. DISCUSSION: This is the third reported case of lomustineoverdose that resulted from supplying the patient with more tablets than needed for 1 dose. Although late hematopoietic recovery may be possible after such a high dose of lomustine, other organ toxicities might be detrimental. CONCLUSIONS: Physicians and pharmacists should avoid supplying more tablets than needed for 1 lomustine dose. High doses of lomustine may cause irreversible multiorgan toxicities.
Authors: Kader Yagiz; Tiffany T Huang; Fernando Lopez Espinoza; Daniel Mendoza; Carlos E Ibañez; Harry E Gruber; Douglas J Jolly; Joan M Robbins Journal: Neuro Oncol Date: 2016-05-10 Impact factor: 12.300