Cyclophosphamide/interferon-α-2a

Abstract

S Cyclophosphamide/interferon-α-2a Hypersensitivity and haematologic toxicities: case reportA 53-year-old man developed hypersensitivity during treatment with cyclophosphamide. During subsequent treatment with interferon-α-2a, he developed the following haematologic toxicities: thrombocytopenia and bleeding.The man, who had a chronic hepatitis C virus infection, presented with dialysis-requiring renal failure. He was diagnosed with lupus-like glomerulonephritis. Treatment included oral cyclophosphamide 150mg daily. After 2 weeks of treatment, he was switched to IV cyclophosphamide 500 mg/m 2 [frequency not stated]. Several days later, he developed daily spiking fevers. He also exhibited a mild transaminase elevation. Chronic hepatitis C stage IV (cirrhosis) was seen with a liver biopsy, and pan-cultures did not show signs of infection. Cyclophosphamide hypersensitivity was thought to be the cause of his fevers. He remained oliguric, with suspected treatment toxicity and without appreciable renal recovery.Cyclophosphamide was withdrawn. The man's transaminase elevation and fevers resolved. He was started on interferon-α-2a [dosage, route and duration of treatment to reaction onset not stated; indication not clearly stated], which was later withdrawn due to thrombocytopenia and bleeding. The thrombocytopenia and bleeding resolved, and he continued haemodialysis for over 18 months.