Severe dactinomycin overdose in an 18-month-old child

✍ Scribed by Brogan, Thomas V.; Mellema, James D.; Jardine, David S.

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 43 KB
• Volume: 33
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/(sici)1096-911x(199911)33:5<506::aid-mpo14>3.0.co;2-l

✦ Synopsis

Dactinomycin is an antineoplastic antibiotic used in the treatment of a variety of tumors, including Wilms tumor, soft-tissue sarcomas, testicular cancer, lymphomas, and breast cancer [1][2][3]. The reported extrahematopoetic toxicities are mild and include nausea, vomiting, ulcers of the gastrointestinal mucosa, and elevation of liver enzymes. Reports of severe toxicity with therapeutic doses [3] or overdoses [4] of dactinomycin are uncommon. Choonara et al. [4] describe a case of a 17year-old boy who received a total dose of 3.3 mg/m 2 (0.1 mg/kg) who had severe and prolonged myelosuppression, electrolyte abnormalities, generalized seizures, and skin rash. Our experience with an 18-month-old boy who received an overdose of dactinomycin is of interest because of the massive amount administered, the severe acute toxicity affecting many organs, and the prolonged complications.