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Jolivot PA, Poinsignon V, Paci A, Guidet B, Pichereau C, Fernandez C, Hindlet P. A case of melphalan sustained accumulation in an 80-year old patient. Int J Clin Pharm 2015; 37:984-7. [PMID: 26394785 DOI: 10.1007/s11096-015-0197-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 09/11/2015] [Indexed: 10/23/2022]
Abstract
Case We report the case of melphalan accumulation in an 80-year old female with multiple myeloma. Her initial health status was good except for a moderate chronic renal failure (estimated glomerular filtration rate: 31 ml/min) and anemia. Among other drugs, her usual treatment included trimethoprim/sulfamethoxazole and the patient received melphalan from day 1 to day 4 for multiple myeloma. On day 13, she was admitted in intensive care unit for acute renal failure and severe sepsis with pancytopenia. Usual treatments were stopped. Melphalan blood concentrations were 123.6 ng/ml on day 16 and 87.5 ng/ml on day 17 while cerebrospinal fluid concentration was 173.8 ng/ml on day 25. Patient recovered on day 30. Melphalan accumulation may be explained by substrate competition between sulfamethoxazole and melphalan in metabolism pathway and chronic renal failure. Conclusion close clinical and renal monitoring should be performed in patient receiving melphalan and sulfamethoxazole.
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Affiliation(s)
- Pierre-Alain Jolivot
- Service de Pharmacie, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, 75012, Paris, France. .,Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France.
| | - Vianney Poinsignon
- Gustave Roussy Cancer Campus - Service interdépartemental de Pharmacologie et d'Analyse du Médicament (SIPAM), 94800, Villejuif, France
| | - Angelo Paci
- Gustave Roussy Cancer Campus - Service interdépartemental de Pharmacologie et d'Analyse du Médicament (SIPAM), 94800, Villejuif, France
| | - Bertrand Guidet
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France.,Service de Réanimation médicale, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, 75012, Paris, France
| | - Claire Pichereau
- Service de Réanimation médicale, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, 75012, Paris, France
| | - Christine Fernandez
- Service de Pharmacie, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, 75012, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France.,Faculté de Pharmacie, Université Paris-Sud, 92290, Chatenay-Malabry, France
| | - Patrick Hindlet
- Service de Pharmacie, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, 75012, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France.,Faculté de Pharmacie, Université Paris-Sud, 92290, Chatenay-Malabry, France
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Abouraya M, Sacco JC, Hayes K, Thomas S, Kitchens CS, Trepanier LA. Dapsone-associated methemoglobinemia in a patient with slow NAT2*5B haplotype and impaired cytochrome b5 reductase activity. J Clin Pharmacol 2015; 52:272-8. [PMID: 21422237 DOI: 10.1177/0091270010393343] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mahmoud Abouraya
- Department of Medical Sciences, University of Wisconsin-MadisonDivision of Hematology and Oncology, College of Medicine, University of Florida, Gainesville, Florida
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Merrick BA. The plasma proteome, adductome and idiosyncratic toxicity in toxicoproteomics research. BRIEFINGS IN FUNCTIONAL GENOMICS AND PROTEOMICS 2008; 7:35-49. [PMID: 18270218 DOI: 10.1093/bfgp/eln004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Toxicoproteomics uses the discovery potential of proteomics in toxicology research by applying global protein measurement technologies to biofluids and tissues after host exposure to injurious agents. Toxicoproteomic studies thus far have focused on protein profiling of major organs and biofluids such as liver and blood in preclinical species exposed to model toxicants. The slow pace of discovery for new biomarkers, toxicity signatures and mechanistic insights is partially due to the limited proteome coverage derived from analysis of native organs, tissues and body fluids by traditional proteomic platforms. Improved toxicoproteomic analysis would result by combining higher data density LC-MS/MS platforms with stable isotope labelled peptides and parallel use of complementary platforms. Study designs that remove abundant proteins from biofluids, enrich subcellular structures and include cell specific isolation from heterogeneous tissues would greatly increase differential expression capabilities. By leveraging resources from immunology, cell biology and nutrition research communities, toxicoproteomics could make particular contributions in three inter-related areas to advance mechanistic insights and biomarker development: the plasma proteome and circulating microparticles, the adductome and idiosyncratic toxicity.
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Affiliation(s)
- B Alex Merrick
- National Center for Toxicogenomics, National Institute of Environmental Health Sciences, PO Box 12233, Research Triangle Park, NC 27709, USA.
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