[A case in which dihydropyrimidine dehydrogenase deficiency was strongly suspected during adjuvant chemotherapy with capecitabine for colon cancer].

Abstract

Severe toxicity in patients with a deficiency of dihydropyrimidine dehydrogenase(DPD), an enzyme that reduces fluoropyrimidine, is very rare, and reports on this condition are few. Accordingly, diagnosis is very difficult. The patient was 70-year-old man who was admitted for adjuvant chemotherapy with capecitabine(3,600mg/day)for rectal cancer. He was admitted to our hospital because of severe oral mucositis(grade 3)and hand-foot syndrome(grade 3). After hospitalization, he experienced complications with neutropenia(grade 4)and thrombocytopenia(grade 4). The patient died 25 days after the onset of chemotherapy. Despite the measurement of the DPD value in mononuclear cells of peripheral blood and urophanic uracil and dihydrouracil, we were unable to diagnose DPD deficiency. However, we suspected a partial deficiency of DPD on the basis of the clinical course.

• Authors: Toshiaki Toshima, Masahito Kodera, Yutaka Yamashita, Masahiro Oishi, Ken Seshimo, Masao Yamamura, Hiroshi Kato, Hideaki Ikeda, Kenji Mizuno
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 40 Issue 11 Pg. 1549-52 (Nov 2013) ISSN: 0385-0684 [Print] Japan
• PMID: 24231713 (Publication Type: Case Reports, English Abstract, Journal Article, Review)

Chemical References

• Deoxycytidine
• Capecitabine
• Fluorouracil

Topics

• Aged
• Capecitabine
• Chemotherapy, Adjuvant
• Colonic Neoplasms (complications, drug therapy)
• Deoxycytidine (adverse effects, analogs & derivatives, therapeutic use)
• Dihydropyrimidine Dehydrogenase Deficiency (complications)
• Fatal Outcome
• Fluorouracil (adverse effects, analogs & derivatives, therapeutic use)
• Humans
• Male
• Neutropenia (chemically induced)
• Thrombocytopenia (chemically induced)