Paralytic Ileus and Syndrome of Inappropriate Antidiuretic Hormone Secretion Potentially due to an Interaction Between Vincristine and Voriconazole/Posaconazole

Castells, Genís; Rodríguez-Reyes, Montserrat; Chaguaceda, Cristian; Carcelero, Esther; Riu-Viladoms, Gisela

doi:10.1097/mjt.0000000000000880

Cited by 4 publications

(6 citation statements)

References 4 publications

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“…However, hyponatremia has not yet been ascribed to other cytostatic agents used during Protocol I of induction therapy of the ALL-BFM 2009 study (Figure 1A). Known possible potentiators are azole antifungals (itraconazole, voriconazole, posaconazole, ketoconazole) (42)(43)(44)(45)(46)(47). These inhibit catabolism of vinca alkaloids, increasing exposure.…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia During Induction Therapy in Distinct Pediatric Oncological Cohorts: A Retrospective Study

Salvador

Salvador²,

Willeit

et al. 2021

Front. Oncol.

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BackgroundHyponatremia is a well-known adverse event of repeated therapy with vincristine in oncological patients. However, to date, data in pediatric patients with malignant diseases other than acute lymphoblastic leukemia (ALL) are sparse or lacking.Materials and MethodsA retrospective study of 98 pediatric patients was conducted to analyze the incidence of hyponatremia in a Caucasian cohort of newly diagnosed ALL. For comparison, we further examined five other pediatric oncological cohorts (Hodgkin’s disease, Ewing sarcoma, Wilms tumor, benign glioma of the CNS, Langerhans cell histiocytosis) that receive alkaloids in their induction regimes.ResultsWe found a high incidence of hyponatremia (14.7%) in our ALL cohort with a trend toward male patients of elementary school age. None of the affected patients showed neurological symptoms. By comparison, patients from other malignancy groups did not show significant hyponatremia, regardless of their comparable therapy with alkaloids. We here show a noticeable coincidence of hyponatremia and hypertriglyceridemia in ALL patients, indicating a possible role of L-asparaginase-related hypertriglyceridemia in the development of severe hyponatremia in such patients.ConclusionWe report a higher incidence of hyponatremia following vincristine therapy in Caucasian children with ALL than published before. This hyponatremia could not be demonstrated in other oncologic cohorts treated with alkaloids. L-Asparaginase-induced hypertriglyceridemia may play a role in the certainly multifactorial development of hyponatremia in childhood leukemia.

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Section: Discussionmentioning

confidence: 99%

Hyponatremia During Induction Therapy in Distinct Pediatric Oncological Cohorts: A Retrospective Study

Salvador

Salvador²,

Willeit

et al. 2021

Front. Oncol.

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“…14 This case report describes a patient who was diagnosed with ileus due to the interaction of VAs with posaconazole. Since Bohme et al 15 reported the first cases of paralytic ileus associated with VCR and itraconazole in four patients with ALL, there have been 15 additional cases of ileus due to VCR and itraconazole, 3 cases due to VCR and posaconazole, 2 cases due to VDS and itraconazole, and 1 case due to VCR and fluconazole published in PubMed [15][16][17][18][19][20][21][22][23][24][25][26][27] (Table 2). The sex of 24 of these 25 patients was reported, and they comprised 14 male and 10 female patients.…”

Section: Discussionmentioning

confidence: 99%

“… 32 Notably, several cases of ileus caused by coadministration of VAs and posaconazole were observed in recent years. 24 , 26 , 27 Alavi and Ebadi 24 reported that an 8-year-old boy with T-cell ALL was diagnosed with paralytic ileus after receiving combined treatment with oral posaconazole and VCR. Pekpak et al.…”

Section: Discussionmentioning

confidence: 99%

“…coadministration of VAs and posaconazole were observed in recent years. 24,26,27 Alavi and Ebadi 24 reported that an 8-year-old boy with T-cell ALL was diagnosed with paralytic ileus after receiving combined treatment with oral posaconazole and VCR. Pekpak et al 27 described a 14-yearold girl with B-cell ALL who developed abdominal pain and constipation after coadministration of VCR and oral posaconazole.…”

Section: Data Availability Statementmentioning

confidence: 99%

“…Pekpak et al 27 described a 14-yearold girl with B-cell ALL who developed abdominal pain and constipation after coadministration of VCR and oral posaconazole. Castells et al 26 reported a 49year-old man with ALL who developed paralytic ileus mediated by voriconazole, followed by oral posaconazole alongside VCR. Posaconazole is a second-generation triazole agent with the broadest antifungal spectrum among antifungal triazole agents.…”

Section: Data Availability Statementmentioning

confidence: 99%

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Ileus induced by the combination of vinca alkaloids and posaconazole in a patient with acute lymphoblastic leukemia: a case report and literature review

Li,

Gong,

Zhao

et al. 2023

J Int Med Res

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Vinca alkaloid (VA)-induced ileus, a rare but severe autonomic neuropathy, can be enhanced by concomitant use of antifungal triazole agents. We herein present a case of VA-induced ileus in a 17-year-old girl who was diagnosed with B-cell acute lymphoblastic leukemia. On day 1, the patient received cyclophosphamide, vincristine, and methylprednisolone. On day 2, she began treatment with posaconazole oral suspension at 200 mg three times daily for prophylaxis against invasive fungal infection. On day 5, she began induction therapy consisting of vindesine, methylprednisolone, daunorubicin, and cyclophosphamide. The patient developed severe abdominal pain with marked constipation on day 11 and was diagnosed with incomplete ileus. After switching the antifungal agent to micafungin, performing gastrointestinal decompression, administering parenteral nutrition, and omitting the fourth dose of vindesine, the ileus symptoms were relieved. This case emphasizes the potential interaction between VAs and posaconazole. We also herein present a review of the literature on ileus caused by the combination of VAs and antifungal triazole agents. In clinical practice, physicians and pharmacists should be aware of the possibility of ileus caused by the use of VAs in combination with posaconazole. It is important to reduce complications during chemotherapy to improve patients’ prognosis.

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Triazoles/vincristine interaction

2020

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Paralytic Ileus and Syndrome of Inappropriate Antidiuretic Hormone Secretion Potentially due to an Interaction Between Vincristine and Voriconazole/Posaconazole

Cited by 4 publications

References 4 publications

Hyponatremia During Induction Therapy in Distinct Pediatric Oncological Cohorts: A Retrospective Study

Hyponatremia During Induction Therapy in Distinct Pediatric Oncological Cohorts: A Retrospective Study

Ileus induced by the combination of vinca alkaloids and posaconazole in a patient with acute lymphoblastic leukemia: a case report and literature review

Triazoles/vincristine interaction

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