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Presentation date

2021

College, Institute, or Department

Pediatrics

Faculty Mentor

Jill Beck

Research Mentor

Jill Beck

Abstract

Background: Pediatric Acute Lymphoblastic Leukemia (ALL) patients undergoing intensive treatment are considered at high risk for opportunistic infections. To prevent invasive fungal infection, some patients receive antifungal prophylaxis such as fluconazole. As a consequence, an increase in vincristine toxicity has been associated with the co-administration of antifungal prophylaxis. We analyzed whether the use of fluconazole prophylaxis impacts vincristine’s side effects during induction therapy. Method: We conducted a retrospective chart review of all pediatric (age 0-18 years) patients diagnosed with ALL at Children’s Hospital and Medical Center in Omaha, Nebraska from July 2013-May 2021. Patients were divided into two groups based on whether or not they received fluconazole. Incidence of fungal infection, rate and grade of peripheral neuropathy, and prescription for gabapentin (treatment for peripheral neuropathy) were collected for both groups. Results: We had 157 ALL patients, of which 72 patients received fluconazole, and 85 patients did not receive fluconazole. There was no significant difference between fluconazole use and increased incidence of peripheral neuropathy (p value= 0.28) or incidence of hyponatremia (p value =Conclusion: We did not find a statistically significant difference that the use of concomitant fluconazole with vincristine increased the risk of peripheral neuropathy or hyponatremia.

Keywords

Vincristine, Fluconazole, Acute Lymphoblastic Leukemia, Invasive Fungal Infection, Neuropathy

Pediatric Acute Lymphoblastic Leukemia Patients and Potential Risk for Vincristine Side Effects with Concomitant Fluconazole

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