Potentiation of vincristine toxicity by itraconazole in children with lymphoid malignancies

Kamaluddin, Muhammad Totong; McNally, Paul; Breatnach, Fin; O’Marcaigh, Aengus; Webb, David; Odell, Edward; Scanlon, Paul D.; Butler, K; O’Meara, Anne

doi:10.1111/j.1651-2227.2001.tb03257.x

Cited by 57 publications

(3 citation statements)

References 14 publications

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“…The first hyponatremic episode in our ALL cohort started on average between days 27 and 28 (average day 27.6) but occurred earlier or later in some patients (range from day 12 to day 39 after start of therapy, Figure 2A). This is consonant with others' observations, which place the onset of hyponatremia approximately 7 days or even longer after receiving vincristine intravenously (7,9,16,48,49). We propose, as suggested elsewhere (17), that development of marked hyponatremia associated with vinca alkaloids definitely requires repeated administration of vincristine.…”

Section: Discussionsupporting

confidence: 91%

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: Discussionsupporting

confidence: 91%

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%

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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“…Vinca alkaloids, such as vincristine, induce hyponatremia through SIADH [145][146][147]. We should note that the simultaneous administration of vincristine with azoles is contraindicated, as the latter inhibit vincristine metabolism and, subsequently, may exacerbate the adverse effects of this drug, including neurotoxicity and hyponatremia [148,149]. CD19 + CAR T-cells used for the treatment of relapsed/refractory ALL may cause hyponatremia due to hypercytokinemia and elevated IL-6, which stimulates the hypothalamus for the inappropriate release of ADH [150].…”

Section: Hyponatremia Related To Pharmacological Agents Used In the Tmentioning

confidence: 99%

Hyponatremia in Patients with Hematologic Diseases

Koumpis

Florentin

Hatzimichael

et al. 2020

JCM

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Hyponatremia is the most common electrolyte disorder in clinical practice and is associated with increased morbidity and mortality. It is frequently encountered in hematologic patients with either benign or malignant diseases. Several underlying mechanisms, such as hypovolemia, infections, toxins, renal, endocrine, cardiac, and liver disorders, as well as the use of certain drugs appear to be involved in the development or the persistence of hyponatremia. This review describes the pathophysiology of hyponatremia and discusses thoroughly the contributing factors and mechanisms that may be encountered specifically in patients with hematologic disorders. The involvement of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion and renal salt wasting syndrome (RSWS) in the development of hyponatremia in such patients, as well as their differential diagnosis and management, are also presented. Furthermore, the distinction between true hyponatremia and pseudohyponatremia is explained. Finally, a practical algorithm for the evaluation of hyponatremia in hematologic patients, as well as the principles of hyponatremia management, are included in this review.

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Potentiation of vincristine toxicity by itraconazole in children with lymphoid malignancies

Cited by 57 publications

References 14 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

Hyponatremia in Patients with Hematologic Diseases

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