Secondary acute leukemia induced by oral etoposide:a case report
A 66-year-old female patient underwent ovarian cancer cell reduction for stage ⅢC ovarian cancer,and was given 8 courses of chemotherapy with paclitaxel+carboplatin.The tumor recurred 3 years later,and chemotherapy with paclitaxel+carboplatin regimen was given for 6 courses.5 months later,the tumor recurred for the second time,and etoposide soft capsule was given at a specific dose of 100 mg·m-2 orally daily,and discontinued after 14 days of continuous use,repeated every 3 weeks.Ten months later,the patient was admitted to the hospital due to intermittent afternoon hypothermia and severe platelet reduction.Etoposide was stopped immediately,and the symptomatic and supportive treatments such as infusion of fresh platelets,recombinant human thrombopoietin injection caffeic acid tablets and other platelet-boosting treatments,red cell suspension,iron replenishment,empirical anti-inflammatory and antipyretic were given,but the efficacy was not obvious.Bone marrow puncture biopsy was performed to confirm acute leukemia,the type to be determined.The patient died 80 days after etoposide discontinuation due to septic shock and systemic multifunctional organ failure.It is the first time to report the case of etoposide-induced secondary acute leukemia in China.Based on the Adverse Drug Reaction Reporting and Monitoring Management Measures,the correlation evaluation was performed,and the result is"probably relevant".The correlation between etoposide and adverse reactions was rated by Naranjo's assessment scale,and the result was"probably relevant".In this paper,the anticancer mechanism and related adverse reactions of etoposide were reviewed,and the mechanism that etoposide may cause secondary acute leukemia was analyzed to improve the safety of etoposide in clinical application.
EtoposideSecondary acute leukemiaAdverse drug reaction
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