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Thiotepa-induced cutaneous toxicity in pediatric patients: Case report and implementation of preventive care

Guy Van Schandevyl1, Tiene Bauters2

  • 11 Department of Hematology and Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|September 7, 2018
PubMed

Insights

High-dose thiotepa can cause skin toxicity in pediatric patients undergoing stem cell transplantation. Implementing preventive care guidelines significantly reduced the incidence and severity of thiotepa toxidermia.

Area of Science:

  • Oncology
  • Pharmacology
  • Dermatology

Background:

  • Thiotepa is a lipophilic alkylating agent used in high-dose conditioning regimens before autologous stem cell transplantation.
  • Potential excretion of thiotepa or its metabolites via the skin suggests a risk of cutaneous toxicity.

Observation:

  • A case of severe thiotepa toxidermia was observed in a pediatric patient with medulloblastoma treated with high-dose thiotepa.
  • The skin lesions were characteristic of drug-induced toxicity, prompting a review of management strategies.

Findings:

  • Implementation of preventive care guidelines in 2014 led to a significant reduction in cutaneous toxicity.
  • In a retrospective follow-up of 26 pediatric patients, only one experienced toxicity after guideline implementation, with subsequent cases showing only mild reactions.

Implications:

  • Preventive skin care measures are crucial for minimizing thiotepa-induced cutaneous toxicity in pediatric patients.
  • Updating the Summary of Product Characteristics with clear preventive instructions is recommended to enhance patient safety.

Keywords:
Thiotepacase reportchildrencutaneous toxicityguidelines

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