2005
DOI: 10.1007/s00280-005-0139-8 View full text |Buy / Rent full text
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Abstract: This report here is the case of a 52-year-old male patient who suffered from extremely severe haematological toxicities (G4 neutropenia, G4 thrombocytopenia) while undergoing Xelox (Xeloda + Oxaliplatin) treatment for his multifocal hepatocarcinoma. Despite appropriate supportive treatment, his condition quickly deteriorated and led to death. It was hypothesized that dihydropyrimidine deshydrogenase (DPD) gene polymorphism could be, at least in part, responsible for this fatal outcome. To test this hypothesis,… Show more

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“…Toxic deaths have been reported following capecitabine treatment of advanced breast cancer in elderly women (30), but with no mention of DPD deficiency in these cases. More recently, a case report of lethal toxicity after capecitabine plus oxaliplatin administration was reported in a 58-year-old male patient treated for multifocal hepatocarcinoma (31). The patient was not carrying the IVS14 + 1G>A DPD mutation but exhibited an abnormal uracil/dihydrouracil ratio with a value at 5.0, close to that of the present case report.…”
Section: Discussionsupporting
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“…Toxic deaths have been reported following capecitabine treatment of advanced breast cancer in elderly women (30), but with no mention of DPD deficiency in these cases. More recently, a case report of lethal toxicity after capecitabine plus oxaliplatin administration was reported in a 58-year-old male patient treated for multifocal hepatocarcinoma (31). The patient was not carrying the IVS14 + 1G>A DPD mutation but exhibited an abnormal uracil/dihydrouracil ratio with a value at 5.0, close to that of the present case report.…”
Section: Discussionsupporting
“…The activity of DPD enzyme was also measured, and none of the patients had impairment in its function. The concentration range of DPD enzyme in this study was 179.2 -1589 µg/L, and there was a significant relationship between the incidence of oral mucositis, severe diarrhea, and bone marrow suppression with DPD serum concentration (15).…”
Section: Discussionmentioning
“…However, no relationship was observed between DPD concentration and response to treatment (14). Another study conducted in China by Ciccolini et al (15), examined the relationship between the incidence of 5-FU complications and the concentration of DPD in gastric cancer. In this study, 36 patients treated with paclitaxel, leucoverin, and 5-FU were assessed.…”
Section: Discussionmentioning
“…A total of 13% of patients experienced grade III -IV toxicities; all in accordance with previously published results. 10 Oxaliplatin, in combination with 5-FU, is known to result in higher frequencies of peripheral neuropathy than 5-FU alone. 39 In the present study, 22% (6/27 patients) of the patients receiving the FOLFOX regimen experienced peripheral neuropathy compared with none of the patients on the Nordic or capecitabine regimens.…”
Section: Discussionmentioning
“…9 Identification of patients at risk of druginduced side-effects before 5-FU treatment could enable timely reduction or selection of alternative treatment. 10 Little is known about predictors of toxicity in patients with CRC treated with 5-FU-based chemotherapy. It is widely recognized that confounding environmental, physiological and inherited genetic factors play an important role in the variability of treatment outcome.…”
Section: Gene Variants In Dpyd Mthfr and Tyms Predict 5-fu-related Tmentioning