Hypersensitivity to procarbazine (Matulane®) manifested by fever and pleuropulmonary reaction

Jones, Stephen E.; Moore, M. R.; Blank, Norman; Castellino, Ronald A.

doi:10.1002/1097-0142(197202)29:2<498::aid-cncr2820290240>3.0.co;2-o

Cited by 78 publications

(26 citation statements)

References 10 publications

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“…While these reactions are well known side effects for some certain chemotherapeutics, procarbazine related hypersensitivity reactions including fever, skin reactions, and pulmonary reactions have been reported uncommonly. [1][2][3][4][5][6][7][8][9][10][11][12][13] Procarbazine is effectively used in combination chemotherapy regimens for treatment of HL.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphocyte counts were 510 cell/mm 3 . Chest radiograph on admission showed diffuse bilaterally interstitial pneumonic infiltrations (Figure 1a).…”

Section: Case Reportmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Hypersensitivity to procarbazine is particularly uncommon during childhood. [6][7][8] Here we report on a child with Hodgkin's lymphoma (HL) who developed procarbazine induced skin hypersensitivity reactions, and then severe pneumonia due to the respiratory syncytial virus (RSV) while receiving procarbazine, and bleomycin containing chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Hypersensitivity to Procarbazine and Severe RSV Pneumonia in a Child with Hodgkin’s Lymphoma

Ince¹

2011

UHOD

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Herein we report respiratory syncytial virus (RSV) pneumonia in a child who had hypersensitivity to procarbazine. Urticarial plaques, maculopapular rash occurred in a child with Hodgkin's lymphoma while receiving procarbazine. Clinical improvement was achieved by withdrawal of procarbazine, administration of corticosteroids, diphenhydramine. After receiving the next course with bleomycin containing chemotherapy, RSV pneumonia developed which required prolonged mechanical ventilation and was treated with oral ribavirin. Hypersensitivity to procarbazine can be a life treating condition. Omitting procarbazine may be necessary. Respiratory syncytial virus pneumonia in the setting of both immunsupression and procarbazine / bleomycin toxicity may have a more serious course.Keywords: Procarbazine, Chemotherapy, Hypersensitivity, Skin reaction, Pulmonary toxicity, Treatment, Child, Respiratory Syncytial virus, Pneumonia ÖZET Hodgkin Lenfomal› Bir Çocukta Geliflen Prokarbazin Hipersensitivitesi ve A¤›r RSV PnömonisiProkarbazin hipersensitivitesi olan bir çocukta geliflen respiratuar sinsityal virus (RSV) pnömonisi bildirildi. Hodgkin lenfomal› bir çocukta prokarbazin al›yorken ürtiker plaklar›, makülopapüler döküntü geliflti. Prokarbazinin kesilmesi, kortikosteroid ve difenhidramin uygulamalar›yla klinik iyileflme sa¤land›. Bir sonraki kemoterapi küründe bleomisin içeren flema uyguland›ktan sonra hastada uzun süreli mekanik ventilasyon gerektiren RSV pnömonisi geliflti ve oral ribavirin ile tedavi edildi. Prokarbazin hipersensitivitesi hayat› tehdit edebilen bir tablodur. Prokarbazinin tedaviden ç›kar›lmas›n› gerektirebilir. ‹mmün bask›lanma, prokarbazin / bleomisin toksisiteleri zemininde geliflen RSV pnömonisi çok daha a¤›r seyredebilir.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Lymphocyte counts were 510 cell/mm 3 . Chest radiograph on admission showed diffuse bilaterally interstitial pneumonic infiltrations (Figure 1a).…”

Section: Case Reportmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hypersensitivity to Procarbazine and Severe RSV Pneumonia in a Child with Hodgkin’s Lymphoma

Ince¹

2011

UHOD

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“…Peripheral eosinophilia has been observed alongside pneumonitis caused by bleomycin (14), procarbazine (12,13). and methotrexate (1 I , 22), suggesting an allergic etiology.…”

Section: I4mentioning

confidence: 99%

“…Dose-related toxic effects have been demonstrated for chlorambucil ( l ) , busulphan (11, carmustine (2), lomustine (3), bleomycin (4, 5 ) , and peplomycin (6). Allergic mechanisms may mediate pulmonary damage caused by cyclophosphamide (7)(8)(9), methotrexate (10, ll), procarbazine (12,13), and bleomycin (5, 14, 15). The occasional pulmonary toxic effect of low-dose bleomycin has been explained by idiosyncrasy (16).…”

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confidence: 99%

Pulmonary Toxicity of Cytotoxic and Immunosuppressive Agents: A Review

Lehne

Lote

1990

Acta Oncologica

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Dose-intensification of procarbazine, CCNU (lomustine), vincristine (PCV) with peripheral blood stem cell support in young patients with gliomas

Jakacki

Jamison

Mathews

et al. 1998

Med. Pediatr. Oncol.

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Background The regimen of procarbazine, CCNU, and vincristine is active against gliomas. Previous attempts at dose‐intensification have been unsuccesful because of delayed and cumulative myelosuppression. We sought to determine whether peripheral blood stem cell (PBSC) infusions would allow dose‐escalation and time compression. Procedure Eleven patients, age 2.8–35.9 years, with newly diagnosed (n = 10) or recurrent (n = 1) gliomas underwent PBSC harvesting after mobilization with G‐CSF. Chemotherapy consisted of CCNU 130 mg/m2 on day 0, vincristine 1.5 mg/m2 on days 0 and 7, and procarbazine 150 mg/m2 on days 1–7. PBSCs were reinfused on day 9 of each course. Four courses of chemotherapy were administered 28 days apart or when counts recovered. Involved field radiation was administered to newly diagnosed high‐grade glioma patients following recovery from chemotherapy. Results Compared to the standard PCV regimen given every 6 weeks, dose intensity received was 1.7‐ and 1.8‐fold greater for CCNU and procarbazine. Chemotherapy was delivered on time in 33/41 (80.5%) courses. Four courses (9.8%) were complicated by absolute neutrophil counts <200/μL; platelet nadirs < 50,000/μL occurred in two courses (4.9%). Fever with neutropenia complicated three courses. Eight of 9 patients with measurable disease had an objective decrease in tumor size and/or decreased enhancement. Median survival for patients with high‐grade gliomas (n = 6) was 13 months. Conclusions Dose‐intensification of PCV is possible using PBSCs. Med. Pediatr. Oncol. 31:483–490, 1998. © 1998 Wiley‐Liss, Inc.

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Hypersensitivity to procarbazine (Matulane®) manifested by fever and pleuropulmonary reaction

Cited by 78 publications

References 10 publications

Hypersensitivity to Procarbazine and Severe RSV Pneumonia in a Child with Hodgkin’s Lymphoma

Hypersensitivity to Procarbazine and Severe RSV Pneumonia in a Child with Hodgkin’s Lymphoma

Pulmonary Toxicity of Cytotoxic and Immunosuppressive Agents: A Review

Dose-intensification of procarbazine, CCNU (lomustine), vincristine (PCV) with peripheral blood stem cell support in young patients with gliomas

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