ACUTE-PANCREATITIS ASSOCIATED WITH CONTINUOUS-INFUSION CYTARABINE THERAPY - A CASE-REPORT

BACKGROUND. While acute pancreatitis is a recognized complication of n umerous drugs, cytarabine's role in causing this complication is contr oversial. Approximately 15 cases have been reported io the Food and Dr ug Administration linking cytarabine with pancreas-related toxicities. Previous case reports have been complicated by comorbid illnesses and the coadministration of other drugs associated with acute pancreatiti s. METHODS. This report describes the clinical course of a patient wit h acute myelogenous leukemia (AML) who developed recurrent pancreatiti s associated with cytarabine therapy. RESULTS. A male age 36 years wit h French-American-British M5B acute myelogenous leukemia received indu ction cytarabine (200 mg/m(2)/day) by continuous infusion for days, an d subsequently developed acute pancreatitis. The patient was rechallen ged with intermittent, bolus, high dose cytarabine (HDAC) (3 g/m(2)bid administered over 3 hours) during the following intensification treat ment, but did not develop clinical acute pancreatitis. Retreatment wit h continuous infusion cytarabine at a later time resulted in recurrenc e of acute pancreatitis.CONCLUSIONS. This case illustrates that cytara bine treatment may cause acute pancreatitis, and that this toxicity ma y be schedule dependent. In those with known sensitivity to cytarabine , altering the administration technique may avoid this complication. ( C) 1996 American Cancer Society.