Clinical Analysis of Adverse Drug Reactions between Vincristine and Triazoles in Children with Acute Lymphoblastic Leukemia
Lihua Yang, Lihua Yu, Xinxin Chen, Yanqun Hu, Bin Wang
Department of Pediatric Hematology and Oncology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China (mainland)
Med Sci Monit 2015; 21:1656-1661
Vincristine (VCR) is a major chemotherapy drug for treatment of childhood acute lymphoblastic leukemia (ALL). Triazole antifungal drugs (AFD) are the main agents for the prevention/treatment of invasive fungal infection (IFI), a common complication during the treatment of ALL. This study investigated the adverse drug reactions (ADRs) between VCR and AFD.
MATERIAL AND METHODS: A retrospective study was performed on 68 children with ALL (39 boys and 29 girls, median age: 5 years) who were treated with VCR chemotherapy (a total of 136 cases, including both induction and reinduction phases) from January 2012 to December 2013 in our hospital. These cases were divided into 4 groups: the control group without AFD prevention/treatment (n=44), the Itra group receiving itraconazole oral solution (n=44), the Fluc group receiving intravenous fluconazole (n=42), and the Vori group receiving voriconazole oral tablets (n=6). The ADRs in each group was recorded and compared.
RESULTS: The incidence of ADRs in the Itra and Vori groups were significantly higher compared with the Fluc and the control group (P<0.05). The incidence of ADRs in the Itra group was significantly higher than that in the Vori group, whereas there was no difference in the incidence between the Fluc and control group.
CONCLUSIONS: Given the lower incidence of ADRs between VCR and fluconazole compared with voriconazole or itraconazole, it is relatively safer to use fluconazole in ALL patients receiving VCR chemotherapy. The occurrence of ADRs should be closely monitored when triazoles must be administered concomitantly with VCR.
Keywords: Antifungal Agents - adverse effects, Antineoplastic Agents, Phytogenic - adverse effects, Child, Child, Preschool, Fluconazole - therapeutic use, Itraconazole - therapeutic use, Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy, Time Factors, Vincristine - therapeutic use, Voriconazole - therapeutic use