Repeatable acute rhabdomyolysis with multiple organ dysfunction because of interferon alpha and dacarbazine treatment in metastatic melanoma

Acute rhabdomyolysis as a complication of interferon treatment for stage IIIc melanoma

BACKGROUND

Interferon alfa-2b is a treatment option for select patients with stage 3 melanoma.

OBJECTIVE

To highlight the potential complication of acute rhabdomyolysis from interferon alfa-2b in this patient population.

METHODS

We present a case of a 63-year-old female with stage IIIc melanoma who developed acute rhabdomyolysis after completing 2 of 4 weeks of induction with high-dose interferon alfa-2b. She recovered after hydration with intravenous fluids and discontinuation of interferon alfa-2b.

RESULTS

Review of the literature revealed eight cases of reported rhabdomyolysis triggered by interferon use, including four cases of melanoma.

CONCLUSION

In patients treated with interferon, especially at high doses, screening for creatine kinase and myoglobinuria should be performed if the patient develops symptoms suggestive of acute rhabdomyolysis.

Interdisciplinary management recommendations for toxicity associated with interferon-alfa therapy

SUMMARY

Adjuvant interferon-alpha (IFN-alpha) therapy in patients with melanoma has been established as standard therapy since more than 10 years.During IFN-alpha therapy, flu-like symptoms, gastrointestinal disorders, arthralgias and neuropsychiatric symptoms are the most common side effects. The management and prophylaxis of these side effects have been improved by a more detailed understanding of pathophysiologic mechanisms and increased clinical experience. New insights in the relevance of detection of autoantibodies and development of autoimmunity have influenced the clinical pathway substantially. This review covers the pathomechanisms, incidence and optimized therapy of IFN-alpha-associated side effects.