Table 1.
Demographics of 47 patients with toxicity caused by vincristine in combination with antifungal azoles.
| n | Itra | Keto | Posa | Vori | |
|---|---|---|---|---|---|
| Total N | 47 | 35 | 8 | 3 | 1 |
| Age (median years) (range) |
441 | 8 (1 – 68) |
8.5 (2 –12) |
9 (4 – 21) |
5 |
| Age ≤ 5 years, N (%) | 14 (43.8) | 3 (37.5) | 1 (33.3) | 1 (100) | |
| Age 6 – 12 years, N (%) | 5 (15.6) | 5 (62.5) | 1 (33.3) | 0 (0) | |
| Age 13 – 18 years, N (%) | 3 (9.4) | 0 (0) | 0 (0) | 0 (0) | |
| Age > 18 years, N (%) | 10 (31.3) | 0 (0) | 1 (33.3) | 0 (0) | |
| Male/Female, N | 351 | 11/12 | 7/1 | 2/1 | 0/1 |
| Primary diagnosis | 441 | ||||
| ALL, N (%) | 24 (68.6) | 5 (62.5) | 3 (100) | 1 (100) | |
| Anaplastic large cell lymphoma, N (%) | 1 (2.9) | ||||
| Diffuse large B-cell lymphoma, N (%) | 3 (8.6) | ||||
| Follicular lymphoma, N (%) | 1 (2.9) | ||||
| Multiple myeloma, N (%) | 1 (2.9) | ||||
| B cell NHL, N (%) | 1 (2.9) | ||||
| T cell NHL, N (%) | 1 (2.9) | ||||
| Lymphoblastic NHL, N (%) | 3 (37.5) | ||||
| Not reported, N (%) | 3 (8.6 ) | ||||
| Reason for antifungal therapy | |||||
| Primary prophylaxis, N (%) | 31 (88.6) | 8 (100) | |||
| Secondary prophylaxis, N (%) | 1 (2.9) | 2 (66.7) | |||
| Treatment, N (%) | 3 (8.6) | 1 (33.3) | 1 (100) | ||
| Azole dosage regimen | |||||
| Pediatric patients (< 18 yo) | 291 | 2.5 mg/kg/day2 to 8 mg/kg/day IV |
5 to 8 mg/kg/day2 |
7 mg/kg/day po to 50 mg po TID |
Not reported |
| Adult patients (≥ 18 yo) | 111 | 200 mg po day to 200 mg po BID |
400 mg po BID |
||
| Vincristine dosage regimen | 211 | 1.5 mg/m2 qmonth to 2 mg qweek |
1.4 mg/m2 qweek |
1.8 mg (1.5 mg/m2) day 1 and 6 to 2 mg qweek |
Not reported |
| Received nifedipine, N (%) | 111 | 11 (31.4) | 0 (0) | 0 (0) | 0 (0) |
| Received nifedipine before starting vincristine, N (%) | 0 (0) | ||||
| Received nifedipine after starting vincristine, N (%) | 11 (100) | ||||
| Time to adverse drug interaction3, median days (range) | 291 | 9.5 (2 – 28) |
13.5 (12 – 15) |
30 | |
| Number of vincristine doses given4, median (range) | 291 | 2 (1 – 4) |
3 (2 – 3) |
2 | |
| Resolution of adverse drug interaction | 361 | ||||
| Recovery, N (%) | 23 (65.7) | 3 (37.5) | 2 (66.7) | 1 (100) | |
| Partial recovery, N (%) | 3 (8.6) | 3 (37.5) | 0 (0) | 0 (0) | |
| No recovery, N (%) | 0 (0) | 0 (0) | 1 (33.3) | 0 (0) | |
| Not reported, N (%) | 9 (25.7) | 2 (25)5 | 0 (0) | 0 (0) |
1
number of cases with available data.
2
route not specified.
3
time to adverse drug interaction with the concomitant administration of vincristine and antifungal azole.
4
number of vincristine doses given with the concomitant administration of antifungal azole after which adverse drug interaction occurred.
5
two patients “not reported” were found to have died from fever, neutropenia, and sepsis.
itra = itraconazole;keto=ketoconazole;posa = posaconazole;vori = voriconazole;N = number of patients;ALL = acute lymphoblastic leukemia;NHL = non-Hodgkin’s lymphoma.