Interferon alpha

Reactions 494 - 26 Mar 1994 ★ S Interferon alpha First report of neuromuscular and skin disorders: case report A 64-year-old man died a few days after developing unusual adverse reactions to interferon-α, administered for progressive and resistant non Hodgkin’s lymphoma. Five years previously the patient had been diagnosed as having non Hodgkin’s lymphoma (NHL). Since that time, he had received various antineoplastic agents and radiotherapy, and had passed through various cycles of remission and disease re-expansion. In June 1991, five years later, (after recent surgery for an abdominal aneurysm) a combination of tri-weekly interferon-α [dosage not stated] and chlorambucil was prescribed, in order to control new disease expansion. One week later, despite the relatively low dose of interferon- α, the patient developed a very strong adverse reaction consisting of high fever and severe myalgia; with pain at the slightest movement, physical activity became impossible. A few day later, purpura and vesicular bullous lesions on the abdomen and lower limbs, developed. Physical examination revealed hepatosplenomegaly, generalised lymphadenomegaly, muscular hypotrophy with no deep reflexes in the lower limbs, and sensitivity abnormalities. Serum myoglobin was abnormally elevated, and there were large amounts of myoglobin in the urine. A diagnosis of necrotic myopathy was made, and although interferon-α treatment had been stopped after a few days and rehydration, nutritional, antimicrobial, steroidal and supportive therapy had been given quickly, the patient died within one week, in a severely wasted condition. Author comment: ‘This particular type of picture might have been influenced by the long course of the disease, the various chemotherapy approaches, or the recent surgery. Since the beneficial effects of α-IFN [interferon-α] in NHL have not been completely established, the dismal fate of this patient, although exceptionally rare, suggests that its use must be carefully evaluated, especially in old and debilitated patients. . . . To the best of our knowledge this is the only report of this side effect to treatment with α-IFN.’ Miglino M, et al. An unusual reaction to alpha interferon in a case of non Hodgkin’s lymphoma. Haematologica 78: 411-413, Nov-Dec 1993 - Switzerland 800255130 1 Reactions 26 Mar 1994 No. 494 0114-9954/10/0494-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Upload
buinga
Category

Documents
view
212
download
0

Embed Size (px):

Transcript of Interferon alpha

Reactions 494 - 26 Mar 1994

★ SInterferon alpha

First report of neuromuscular and skin disorders:case report

A 64-year-old man died a few days after developing unusualadverse reactions to interferon-α, administered for progressiveand resistant non Hodgkin’s lymphoma.

Five years previously the patient had been diagnosed ashaving non Hodgkin’s lymphoma (NHL). Since that time, hehad received various antineoplastic agents and radiotherapy,and had passed through various cycles of remission anddisease re-expansion.

In June 1991, five years later, (after recent surgery for anabdominal aneurysm) a combination of tri-weekly interferon-α[dosage not stated] and chlorambucil was prescribed, in orderto control new disease expansion.

One week later, despite the relatively low dose of interferon-α, the patient developed a very strong adverse reactionconsisting of high fever and severe myalgia; with pain at theslightest movement, physical activity became impossible. Afew day later, purpura and vesicular bullous lesions on theabdomen and lower limbs, developed. Physical examinationrevealed hepatosplenomegaly, generalisedlymphadenomegaly, muscular hypotrophy with no deepreflexes in the lower limbs, and sensitivity abnormalities.Serum myoglobin was abnormally elevated, and there werelarge amounts of myoglobin in the urine.

A diagnosis of necrotic myopathy was made, and althoughinterferon-α treatment had been stopped after a few days andrehydration, nutritional, antimicrobial, steroidal andsupportive therapy had been given quickly, the patient diedwithin one week, in a severely wasted condition.

Author comment: ‘This particular type of picture might havebeen influenced by the long course of the disease, the variouschemotherapy approaches, or the recent surgery. Since thebeneficial effects of α-IFN [interferon-α] in NHL have not beencompletely established, the dismal fate of this patient, althoughexceptionally rare, suggests that its use must be carefullyevaluated, especially in old and debilitated patients. . . . To thebest of our knowledge this is the only report of this side effect totreatment with α-IFN.’Miglino M, et al. An unusual reaction to alpha interferon in a case of nonHodgkin’s lymphoma. Haematologica 78: 411-413, Nov-Dec 1993 -Switzerland 800255130