학술논문

Severe neurological disorders and refractory aspergillosis in an adolescent treated by vincristine and voriconazole.
Document Type
Article
Source
Journal of Clinical Pharmacy & Therapeutics. Apr2018, Vol. 43 Issue 2, p265-268. 4p.
Subject
*CANCER chemotherapy
*DRUG interactions
*LYMPHOBLASTIC leukemia
*NEUROLOGICAL disorders
*NEURALGIA
*NEUROTOXICOLOGY
*PULMONARY aspergillosis
*SYNDROMES
*T cells
*TREATMENT effectiveness
*VINCRISTINE
*SEVERITY of illness index
*DISEASE exacerbation
*ADOLESCENCE
*VORICONAZOLE
*THERAPEUTICS
Language
ISSN
0269-4727
Abstract
Summary: What is known and objective: Voriconazole and vincristine are major therapeutics in paediatric haematology. However, the risk‐benefit ratio of the treatment of invasive aspergillosis with voriconazole in patients receiving vincristine‐based chemotherapy remains unclear. Case description: We report severe peripheral and central neurological disorders in a 14‐year‐old girl with T‐cell acute lymphoblastic leukaemia and pulmonary aspergillosis. The case describes a strong exacerbation by voriconazole of the vincristine‐induced neuropathic pains. It shows the high variability of the trough serum concentration of voriconazole leading to antifungal treatment failure and suggests that its own central neurotoxicity could also be potentiated by vincristine. What is new and conclusion: Given the risk of either insufficient antifungal efficacy or excessive neurological disorders, this case warns on a probable unfavourable risk‐benefit profile of voriconazole during vincristine‐based chemotherapy in adolescents. [ABSTRACT FROM AUTHOR]