Surveillance of adverse drug reactions and drug–drug interactions with pediatric oncology patients in a south Indian tertiary care hospital

Abstract

<jats:sec><jats:title>Objective</jats:title><jats:p> The present study was conducted to evaluate the pattern of occurrence of adverse drug reactions and drug–drug interaction in a pediatric oncology unit of a tertiary care hospital. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A prospective, observational study was conducted in the Department of Pediatric Oncology, Sri Ramachandra Medical College and Hospital, India. Patients were monitored actively for the occurrences of any adverse drug reaction during the study period. Patient's demographic details, clinical, and treatment data were collected for drug–drug interaction analysis. The detected adverse drug reaction was assessed for causality, severity, and preventability. Drug–drug interaction identified was rated based on their level of urgency and the nature of actions necessary to respond to an interaction. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Of 176 patients, 118 were detected for the occurrence of various adverse drug reaction. The majority of the cases were suffering with acute lymphocytic leukemia (67.9%). Vincristine was noted for a maximum number of adverse drug reaction in cytotoxic drugs. Rash is the most frequently occurred reaction. Assessment of causality showed that the majority of cases are “probable” (60.16%). In evaluating the severity of adverse drug reactions, 57.6% reactions were moderately severe and 74.5% of the reactions were preventable. Upon assessing the drug–drug interaction, 38.13% of the prescription needs to be monitored and 10 drug–drug interactions were under the risk category of “X.” The majority of the adverse drug reaction was moderately severe in nature and those were preventable. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Since pediatrics are vulnerable population, they must have a thorough surveillance system for adverse drug reaction and drug–drug interaction; thereby, a positive impact on the medication-use system and improved patient care can be achieved. </jats:p></jats:sec>

Vincristine-Induced Peripheral Neuropathy in Childhood Acute Lymphoblastic Leukemia: Genetic Variation as a Potential Risk Factor

“…Hematological toxicity is one of the uncommon adverse reactions. Mild and recurrent myelosuppression in terms of leukopenia, anemia, and neutropenia ( Johnson et al, 1963 ; Niu et al, 2018 ; Joseph et al, 2020 ) in addition to severe myelosuppression and thrombocytosis may occur ( Carbone et al, 1963 ; Kaufman et al, 1976 ). Different degrees of alopecia may also develop ( Gidding et al, 1999 ), and the reported incidence associated with VCR ranges from 8 to 23.1% ( Niu et al, 2018 ; Joseph et al, 2020 ).…”

“…Mild and recurrent myelosuppression in terms of leukopenia, anemia, and neutropenia ( Johnson et al, 1963 ; Niu et al, 2018 ; Joseph et al, 2020 ) in addition to severe myelosuppression and thrombocytosis may occur ( Carbone et al, 1963 ; Kaufman et al, 1976 ). Different degrees of alopecia may also develop ( Gidding et al, 1999 ), and the reported incidence associated with VCR ranges from 8 to 23.1% ( Niu et al, 2018 ; Joseph et al, 2020 ). Other rare side effects associated with VCR include fever, gastrointestinal ulcers and perforation, myocardial infarction, rashes ( Niu et al, 2018 ; Joseph et al, 2020 ).…”

“…Different degrees of alopecia may also develop ( Gidding et al, 1999 ), and the reported incidence associated with VCR ranges from 8 to 23.1% ( Niu et al, 2018 ; Joseph et al, 2020 ). Other rare side effects associated with VCR include fever, gastrointestinal ulcers and perforation, myocardial infarction, rashes ( Niu et al, 2018 ; Joseph et al, 2020 ).…”

Adverse Drug Reactions in Pediatric Oncohematology: A Systematic Review

“…Using the research strategies defined previously, 7,712 studies were retrieved from PubMed database. Forty articles were considered relevant for eligibility and finally, considering inclusion and exclusion criteria, 14 studies were included in the systematic review (Collins et al, 1974;Mitchell et al, 1988;Queuille et al, 2001;Le et al, 2006;Gallagher et al, 2012;Posthumus et al, 2012;Barrett et al, 2013;Call et al, 2014;Langerová et al, 2014;Makiwane et al, 2019;Dittrich et al, 2020;Joseph et al, 2020;Morales-Ríos et al, 2020;Workalemahu et al, 2020). Due to the characteristics of studies found, a meta-analysis was considered not feasible to be carried out.…”

“…Of the 14 studies included, six were carried out in pediatric oncology and hematology patients, and eight were carried out in general pediatrics and included a clear pediatric oncohematology subgroup. Four studies (Collins et al, 1974;Mitchell et al, 1988;Queuille et al, 2001;Le et al, 2006) were published before 2010, and 10 studies (Gallagher et al, 2012;Posthumus et al, 2012;Barrett et al, 2013;Call et al, 2014;Langerová et al, 2014;Makiwane et al, 2019;Dittrich et al, 2020;Joseph et al, 2020;Morales-Ríos et al, 2020;Workalemahu et al, 2020) were published later.…”