Unpredicted Severe Toxicity after 5-Fluorouracil Treatment due to Dihydropyrimidine Dehydrogenase Deficiency
The Korean Journal of Internal Medicine
;
: 43-45, 2006.
Article
in English
| WPRIM
| ID: wpr-26004
ABSTRACT
Dihydropyrimidine dehydrogenase (DPD) is the initial and rate-limiting enzyme in the catabolism of 5-fluorouracil (5-FU). Thus, patients with a DPD deficiency are at risk of developing severe 5-FU-associated toxicity. A 37-year-old female with gastric cancer underwent a curative operation, followed by adjuvant chemotherapy consisting of 5-FU and epirubicin. After the first cycle of chemotherapy, the patient manifested grade 2 mucositis and febrile neutropenia, and when her treatment was subsequently continued with doxifluridine she developed severe mucositis and febrile neutropenia. A PCR study revealed that her DPD mRNA level was lower than that in a control group. Thus, when considering the routine use of 5-FU for the treatment of cancer patients, an analysis of DPD activity or screening for DPD mutations is warranted in confined patients who experience unpredicted severe toxicity after initial 5-FU administration, even though DPD deficiency is a rare metabolic defect.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Stomach Neoplasms
/
Adenocarcinoma
/
Risk Factors
/
Chemotherapy, Adjuvant
/
Risk Assessment
/
Dihydrouracil Dehydrogenase (NADP)
/
Drug-Related Side Effects and Adverse Reactions
/
Fluorouracil
/
Antimetabolites, Antineoplastic
Type of study:
Etiology study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2006
Type:
Article
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