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Current Oncology
Volume 25
Issue 1
10.3747/co.25.3680
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Article

Procarbazine, Lomustine and Vincristine Toxicity in Low-Grade Gliomas

by
G. Jutras
1,*,
K. Bélanger
1,2,
N. Letarte
2,3,4,
J.-P. Adam
2,4,
D. Roberge
1,2,
B. Lemieux
1,2,
É. Lemieux-Blanchard
1,2,
L. Masucci
1,2,
C. Ménard
1,2,
J.P. Bahary
1,2,
R. Moumdjian
1,2,
F. Berthelet
1,2 and
M. Florescu
1,2
1
Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
2
Centre hospitalier de l’Université de Montréal, Notre-Dame Hospital, Montréal, QC, Canada
3
Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada
4
Department of Pharmacy at chum, Montréal, QC, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(1), 33-39; https://doi.org/10.3747/co.25.3680
Submission received: 8 November 2017 / Revised: 6 December 2017 / Accepted: 10 January 2018 / Published: 1 February 2018

Abstract

Background: Procarbazine, lomustine, and vincristine (PCV) significantly improve survival outcomes in LGG (low-grade gliomas). Administration of PCV to LGG patients increased tremendously over the past years as it went from 2 patients per year between 2005 and 2012 to 23 patients in 2015 only in our centre. However, serious hematological and non-hematological adverse events may occur. The purpose of this study was to evaluate the toxicity of PCV and its clinical relevance in our practice. Methods: We retrospectively reviewed the charts of 57 patients with LGG who received PCV at the Centre hospitalier de l’Université de Montréal between 1 January 2005 and 27 July 2016. Results: Procarbazine, lomustine, and vincristine were associated with severe hematological toxicity as clinically significant grade 3 anemia, neutropenia, and thrombocytopenia occurred in 7%, 10%, and 28% of patients, respectively. Other frequent adverse events such as the increase of liver enzymes, cutaneous rash, neurotoxicity, and vomiting occurred in 65%, 26%, 60%, and 40% of patients, respectively. Patients with prophylactic trimethoprim/sulfamethoxazole had more grade 3 hematological toxicity with PCV, especially anemia (p = 0.040) and thrombocytopenia (p = 0.003) but we found no increase in PCV toxicity in patients on concurrent anticonvulsants. Patients with grade 3 neutropenia had a significantly lower survival (median survival 44.0 months vs. 114.0 months, p = 0.001). Patients who were given PCV at diagnosis had more grade 3 anemia than those who received it at subsequent lines of treatment (p = 0.042). Conclusion: Procarbazine, lomustine, and vincristine increase survival in LGG but were also associated with major hematologic, hepatic, neurologic, and cutaneous toxicity. Anti-Pneumocystis jiroveci pneumonia (PJP) prophylaxis, but not anticonvulsants, enhances hematologic toxicity.
Keywords: chemotherapy; toxicity; gliomas chemotherapy; toxicity; gliomas

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MDPI and ACS Style

Jutras, G.; Bélanger, K.; Letarte, N.; Adam, J.-P.; Roberge, D.; Lemieux, B.; Lemieux-Blanchard, É.; Masucci, L.; Ménard, C.; Bahary, J.P.; et al. Procarbazine, Lomustine and Vincristine Toxicity in Low-Grade Gliomas. Curr. Oncol. 2018, 25, 33-39. https://doi.org/10.3747/co.25.3680

AMA Style

Jutras G, Bélanger K, Letarte N, Adam J-P, Roberge D, Lemieux B, Lemieux-Blanchard É, Masucci L, Ménard C, Bahary JP, et al. Procarbazine, Lomustine and Vincristine Toxicity in Low-Grade Gliomas. Current Oncology. 2018; 25(1):33-39. https://doi.org/10.3747/co.25.3680

Chicago/Turabian Style

Jutras, G., K. Bélanger, N. Letarte, J.-P. Adam, D. Roberge, B. Lemieux, É. Lemieux-Blanchard, L. Masucci, C. Ménard, J.P. Bahary, and et al. 2018. "Procarbazine, Lomustine and Vincristine Toxicity in Low-Grade Gliomas" Current Oncology 25, no. 1: 33-39. https://doi.org/10.3747/co.25.3680

APA Style

Jutras, G., Bélanger, K., Letarte, N., Adam, J. -P., Roberge, D., Lemieux, B., Lemieux-Blanchard, É., Masucci, L., Ménard, C., Bahary, J. P., Moumdjian, R., Berthelet, F., & Florescu, M. (2018). Procarbazine, Lomustine and Vincristine Toxicity in Low-Grade Gliomas. Current Oncology, 25(1), 33-39. https://doi.org/10.3747/co.25.3680

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