Severe neurological disorders and refractory aspergillosis in an adolescent treated by vincristine and voriconazole

S. Quaranta; N. Guillaume; T. Chouaki; A. -S. Lemaire-Hurtel; K. Masmoudi; Youssef Bennis; S. Bodeau; A. Lutun; A. Gourmel; C. Solas

doi:10.1111/jcpt.12603

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Severe neurological disorders and refractory aspergillosis in an adolescent treated by vincristine and voriconazole

S. Quaranta ¹ N. Guillaume ² T. Chouaki ^{3, 4} A. -S. Lemaire-Hurtel K. Masmoudi ⁴ Youssef Bennis ^{4, 5} S. Bodeau A. Lutun A. Gourmel C. Solas ^{6, 7, 8}

1 CISMET - Cytosquelette et Intégration des Signaux du Micro-Environnement Tumoral - UMR 6032

2 INL - DE - INL - Dispositifs Electroniques

INL - Institut des Nanotechnologies de Lyon

3 UPJV - Université de Picardie Jules Verne

4 CHU Amiens-Picardie

5 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517

6 AMU - Aix Marseille Université

7 CRO2 - Centre de Recherches en Oncologie biologique et Oncopharmacologie

8 Pharmacocinétique Toxicocinétique - [Hôpital de la Timone - APHM]

Abstract : What is known and objectiveVoriconazole and vincristine are major therapeutics in paediatric haematology. However, the risk-benefit ratio of the treatment of invasive aspergillosis with voriconazole in patients receiving vincristine-based chemotherapy remains unclear. Case descriptionWe report severe peripheral and central neurological disorders in a 14-year-old girl with T-cell acute lymphoblastic leukaemia and pulmonary aspergillosis. The case describes a strong exacerbation by voriconazole of the vincristine-induced neuropathic pains. It shows the high variability of the trough serum concentration of voriconazole leading to antifungal treatment failure and suggests that its own central neurotoxicity could also be potentiated by vincristine. What is new and conclusionGiven the risk of either insufficient antifungal efficacy or excessive neurological disorders, this case warns on a probable unfavourable risk-benefit profile of voriconazole during vincristine-based chemotherapy in adolescents.

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Sciences du Vivant [q-bio]

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Soumis le : jeudi 10 février 2022 - 15:59:13
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Severe neurological disorders and refractory aspergillosis in an adolescent treated by vincristine and voriconazole

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Severe neurological disorders and refractory aspergillosis in an adolescent treated by vincristine and voriconazole

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